Quality of Life After Poor-Grade Aneurysmal Subarachnoid Hemorrhage. Issue 5 (4th May 2023)

• Record Type: Journal Article
• Authors: Goldberg, Johannes; Z'Graggen, Werner J.; Hlavica, Martin; Branca, Mattia; Marbacher, Serge; D'Alonzo, Donato; Fandino, Javier; Stienen, Martin N.; Neidert, Marian C.; Burkhardt, Jan-Karl; Regli, Luca; Seule, Martin; Roethlisberger, Michel; Guzman, Raphael; Zumofen, Daniel Walter; Maduri, Rodolfo; Daniel, Roy Thomas; El Rahal, Amir; Corniola, Marco V.; Bijlenga, Philippe; Schaller, Karl; Rölz, Roland; Scheiwe, Christian; Shah, Mukesch; Heiland, Dieter Henrik; Schnell, Oliver; Beck, Jürgen; Raabe, Andreas; Fung, Christian
• Is Part Of: Neurosurgery. Volume 92:Issue 5(2023)
• Page Start: 1052
• Page End: 1057
• Publication Date: 2023-05-04
• Subjects: Aneurysmal subarachnoid hemorrhage -- EQ-5D -- Outcome -- Poor grade -- Prospective observational study -- Quality of life -- WFNS grades IV and V; Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1227/neu.0000000000002332
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract : 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. Abstract :