Quality of Life After Poor-Grade Aneurysmal Subarachnoid Hemorrhage.
Journal
Neurosurgery
ISSN: 1524-4040
Titre abrégé: Neurosurgery
Pays: United States
ID NLM: 7802914
Informations de publication
Date de publication:
01 05 2023
01 05 2023
Historique:
received:
25
06
2022
accepted:
31
10
2022
medline:
19
4
2023
pubmed:
27
1
2023
entrez:
26
1
2023
Statut:
ppublish
Résumé
Poor-grade aneurysmal subarachnoid hemorrhage (aSAH) is associated with high mortality and poor disability outcome. Data on quality of life (QoL) among survivors are scarce because patients with poor-grade aSAH are underrepresented in clinical studies reporting on QoL after aSAH. To provide prospective QoL data on survivors of poor-grade aSAH to aid clinical decision making and counseling of relatives. The herniation World Federation of Neurosurgical Societies scale study was a prospective observational multicenter study in patients with poor-grade (World Federation of Neurosurgical Societies grades 4 & 5) aSAH. We collected data during a structured telephone interview 6 and 12 months after ictus. QoL was measured using the EuroQoL - 5 Dimensions - 3 Levels (EQ-5D-3L) questionnaire, with 0 representing a health state equivalent to death and 1 to perfect health. Disability outcome for favorable and unfavorable outcomes was measured with the modified Rankin Scale. Two hundred-fifty patients were enrolled, of whom 237 were included in the analysis after 6 months and 223 after 12 months. After 6 months, 118 (49.8%) patients were alive, and after 12 months, 104 (46.6%) patients were alive. Of those, 95 (80.5%) and 89 (85.6%) reached a favorable outcome with mean EQ-5D-3L index values of 0.85 (±0.18) and 0.86 (±0.18). After 6 and 12 months, 23 (19.5%) and 15 (14.4%) of those alive had an unfavorable outcome with mean EQ-5D-3L index values of 0.27 (±0.25) and 0.19 (±0.14). Despite high initial mortality, the proportion of poor-grade aSAH survivors with good QoL is reasonably large. Only a minority of survivors reports poor QoL and requires permanent care.
Sections du résumé
BACKGROUND
Poor-grade aneurysmal subarachnoid hemorrhage (aSAH) is associated with high mortality and poor disability outcome. Data on quality of life (QoL) among survivors are scarce because patients with poor-grade aSAH are underrepresented in clinical studies reporting on QoL after aSAH.
OBJECTIVE
To provide prospective QoL data on survivors of poor-grade aSAH to aid clinical decision making and counseling of relatives.
METHODS
The herniation World Federation of Neurosurgical Societies scale study was a prospective observational multicenter study in patients with poor-grade (World Federation of Neurosurgical Societies grades 4 & 5) aSAH. We collected data during a structured telephone interview 6 and 12 months after ictus. QoL was measured using the EuroQoL - 5 Dimensions - 3 Levels (EQ-5D-3L) questionnaire, with 0 representing a health state equivalent to death and 1 to perfect health. Disability outcome for favorable and unfavorable outcomes was measured with the modified Rankin Scale.
RESULTS
Two hundred-fifty patients were enrolled, of whom 237 were included in the analysis after 6 months and 223 after 12 months. After 6 months, 118 (49.8%) patients were alive, and after 12 months, 104 (46.6%) patients were alive. Of those, 95 (80.5%) and 89 (85.6%) reached a favorable outcome with mean EQ-5D-3L index values of 0.85 (±0.18) and 0.86 (±0.18). After 6 and 12 months, 23 (19.5%) and 15 (14.4%) of those alive had an unfavorable outcome with mean EQ-5D-3L index values of 0.27 (±0.25) and 0.19 (±0.14).
CONCLUSION
Despite high initial mortality, the proportion of poor-grade aSAH survivors with good QoL is reasonably large. Only a minority of survivors reports poor QoL and requires permanent care.
Identifiants
pubmed: 36700700
doi: 10.1227/neu.0000000000002332
pii: 00006123-202305000-00019
doi:
Banques de données
ClinicalTrials.gov
['NCT02304328']
Types de publication
Observational Study
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1052-1057Informations de copyright
Copyright © Congress of Neurological Surgeons 2023. All rights reserved.
Références
Zhao B, Rabinstein A, Murad MH, Lanzino G, Panni P, Brinjikji W. Surgical and endovascular treatment of poor-grade aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. J Neurosurg Sci. 2017;61(4):403-415.
Schatlo B, Fung C, Stienen MN, et al. Incidence and outcome of aneurysmal subarachnoid hemorrhage. Stroke. 2021;52(1):344-347.
Hua X, Gray A, Wolstenholme J, et al. Survival, dependency, and health-related quality of life in patients with ruptured intracranial aneurysm: 10-year follow-up of the United Kingdom cohort of the international subarachnoid aneurysm trial. Neurosurgery. 2020;88(2):252-260.
Wong GKC, Poon WS, Boet R, et al. Health-related quality of life after aneurysmal subarachnoid hemorrhage: profile and clinical factors. Neurosurgery. 2011;68(6):1556-1561.
Young JM, Morgan BR, Mišić B, Schweizer TA, Ibrahim GM, Macdonald RL. A partial least-squares analysis of health-related quality-of-life outcomes after aneurysmal subarachnoid hemorrhage. Neurosurgery. 2015;77(6):908-915.
Macdonald RL, Hunsche E, Schüler R, Wlodarczyk J, Mayer SA. Quality of life and healthcare resource use associated with angiographic vasospasm after aneurysmal subarachnoid hemorrhage. Stroke. 2012;43(4):1082-1088.
Ali A, Alrabayah T, Abdelhafez I, et al. Patient-reported outcome for endovascular treatment versus microsurgical clipping in aneurysmal subarachnoid hemorrhage. World Neurosurg. 2021;155:e695-e703.
Proust F, Bracard S, Lejeune JP, et al. A randomized controlled study assessing outcome, cognition, autonomy and quality of life in over 70-year-old patients after aneurysmal subarachnoid hemorrhage. Neurochirurgie. 2018;64(6):395-400.
Taufique Z, May T, Meyers E, et al. Predictors of poor quality of life 1 year after subarachnoid hemorrhage. Neurosurgery. 2016;78(2):256-264.
Visser-Meily JA, Rhebergen ML, Rinkel GJE, Van Zandvoort MJ, Post MWM. Long-term health-related quality of life after aneurysmal subarachnoid hemorrhage. Stroke. 2009;40(4):1526-1529.
Raabe A, Beck J, Goldberg J, et al. Herniation World Federation of Neurosurgical Societies Scale improves prediction of outcome in patients with poor-grade aneurysmal subarachnoid hemorrhage. Stroke. 2022:53(7):2346-2351.
Connolly ES, Rabinstein AA, Carhuapoma JR, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage. Stroke. 2012;43(6):1711-1737.
Steiner T, Juvela S, Unterberg A, Jung C, Forsting M, Rinkel G. European Stroke Organization guidelines for the management of intracranial aneurysms and subarachnoid haemorrhage. Cerebrovasc Dis. 2013;35(2):93-112.
Rabin R, Charro FD. EQ-SD: a measure of health status from the EuroQol Group. Ann Med. 2001;33(5):337-343.
Szende A, Janssen B, Cabases J. Self-Reported Population Health: An International Perspective Based on EQ-5D. Springer Open; 2014.
Ramos-Goñi JM, Rivero-Arias O. eq5d: a command to calculate index values for the EQ-5D quality-of-life instrument. Stata J. 2011;11(1):120-125.
Report of World Federation of Neurological Surgeons Committee on a universal subarachnoid hemorrhage grading scale. J Neurosurg. 1988;68(6):985-986.
Schwartz C, Pfefferkorn T, Ebrahimi C, et al. Long-term neurological outcome and quality of life after World Federation of Neurosurgical Societies Grades IV and V aneurysmal subarachnoid hemorrhage in an interdisciplinary treatment concept. Neurosurgery. 2017;80(6):967-974.
Haug T, Sorteberg A, Finset A, Lindegaard K-F, Lundar T, Sorteberg W. Cognitive Functioning and health-related quality of life 1 year after aneurysmal subarachnoid hemorrhage in preoperative comatose patients (Hunt and Hess Grade V patients). Neurosurgery. 2010;66(3):475-485.
Barth M, Thomé C, Schmiedek P, Weiss C, Kasuya H, Vajkoczy P. Characterization of functional outcome and quality of life following subarachnoid hemorrhage in patients treated with and without nicardipine prolonged-release implants. J Neurosurg. 2009;110(5):955-960.
Hop JW, Rinkel GJE, Algra A, Van Gijn J. Changes in functional outcome and quality of life in patients and caregivers after aneurysmal subarachnoid hemorrhage. J Neurosurg. 2001;95(6):957-963.
Sonesson B, Kronvall E, Säveland H, Brandt L, Nilsson OG. Long-term reintegration and quality of life in patients with subarachnoid hemorrhage and a good neurological outcome: findings after more than 20 years. J Neurosurg. 2018;128(3):785-792.
Huhtakangas J, Lehto H, Seppä K, et al. Long-term excess mortality after aneurysmal subarachnoid hemorrhage. Stroke. 2015;46(7):1813-1818.
Nieuwkamp DJ, Algra A, Blomqvist P, et al. Excess mortality and cardiovascular events in patients surviving subarachnoid hemorrhage. Stroke. 2011;42(4):902-907.