Health-Related Quality of Life in Patients with Subarachnoid Haemorrhage

Meyer, Bernhard; Ringel, Florian; Winter, Yaroslav; Spottke, Annika; Gharevi, Nadir; Dams, Judith; Balzer‐Geldsetzer, Monika; Mueller, Ines K.; Klockgether, Thomas; Schramm, Johannes; Urbach, Horst; Dodel, Richard

doi:10.1159/000317078

Cited by 66 publications

(61 citation statements)

References 77 publications

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“…According to the neurological assessment, 45 out of 50 patients do show a cognitive deficit. This finding is further supported by recent publications that report a high incidence of cognitive deficits and the impact on daily life in SAH patients [2,3,5,7]. We suspect that the significant differences between the two specialties in recognizing cognitive and minor somatic deficits may be explained by the time spent on assessment and perspective with respect to the rehabilitation consequences of the deficits.…”

Section: Discussionsupporting

confidence: 81%

“…This might influence the assessment behavior of neurosurgeons shifting the focus away from cognitive deficits. It is only recently that papers have been published with more sophisticated outcome parameters including health-related quality of life, cognitive impairment, and emotional problems [2,6,7]. This reflects the growing interest and the meaning of cognitive impairment after SAH.…”

Section: Discussionmentioning

confidence: 99%

“…Up to 80 % of patients show a reduced health-related quality of life and deficits in neuropsychological functioning 1 year after SAH [2][3][4][5]. Cognitive impairment is one factor that greatly contributes to the reduction in quality of life for these patients [2,6].…”

Section: Introductionmentioning

confidence: 99%

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Clinical assessment of deficits after SAH: hasty neurosurgeons and accurate neurologists

et al. 2012

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For survivors of aneurysmal subarachnoid hemorrhage (SAH), somatic and cognitive deficits can affect long-term outcomes. We were interested in comparing the deficits identified in SAH patients, including cognitive deficits, at discharge by neurosurgeons and deficits identified by neurologists upon admission to the rehabilitation unit on the same day. The assessment of deficits might have an impact on referring patients to rehabilitation. This retrospective study included 494 SAH patients treated between 2005 and 2010. Of these, 50 patients were discharged to an affiliated rehabilitation unit. Deficits were grouped into 18 categories and summarized into three groups: major somatic, minor somatic, and cognitive deficits. Major somatic deficits were identified in 16 and 20 patients (p = 0.53), minor somatic deficits in 16 and 44 (p \ 0.0001) patients, and cognitive deficits in 36 and 45 (p \ 0.04) patients by neurosurgeons and neurologists, respectively. The absolute number of deficits in daily activities identified by the neurosurgeon and neurologist were 21 and 31 major somatic deficits (p = 0.2), 18 and 97 minor somatic deficits (p \ 0.0001), and 61 and 147 cognitive deficits (p \ 0.0001), respectively. Significant differences in assessment of cognitive and minor somatic deficits between neurosurgeons and neurologists exist. Based on these findings, it is evident that for the neurosurgeon, there needs to be an increased awareness of the assessment of cognitive deficits and a more routine interdisciplinary approach, including the use of neuropsychological evaluations, to ensure a better triage of patients to rehabilitation or for discharge home.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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Clinical assessment of deficits after SAH: hasty neurosurgeons and accurate neurologists

et al. 2012

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“…Still, many of these patients need weeks or months to regain their premorbid level, and resume work, if at all. Also, a majority of patients with an aSAH have to reduce their workload significantly, undergo professional retraining to a less demanding occupation, or have problems in relationships, family life, or leisure activities, indicating post-hemorrhagic difficulties due to e.g., cognitive deficits, depression, fatigue, or post-traumatic stress disorder [28, 47,48,56,57,68]. These facts clearly call for a more comprehensive assessment of those patients.…”

Section: Introductionmentioning

confidence: 99%

Call for uniform neuropsychological assessment after aneurysmal subarachnoid hemorrhage: Swiss recommendations

et al. 2015

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“…Furthermore, women have been linked with higher recurrence rates 46 and lower quality of life after aSAH. 33,37 The reason why women may have poorer outcomes is unclear. Activation of the sympathetic nervous system is thought to play a major role in the genesis of vasospasm.…”

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confidence: 99%

Subarachnoid hemorrhage and the female sex: analysis of risk factors, aneurysm characteristics, and outcomes

Hamdan

Barnes

Mitchell

2014

JNS

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Object The pathophysiology of aneurysmal subarachnoid hemorrhage (aSAH) is unclear. Sex may play a role in the outcome of patients with aSAH. Methods The authors retrospectively identified 617 patients with aSAH (April 2005 to February 2010) and analyzed sex differences in risk factors (age, hypertension, smoking, alcohol consumption, and family history), admission-related factors (World Federation of Neurosurgical Societies grade and admission delay), aneurysm characteristics (site, side, location, and multiplicity), and outcomes (treatment modalities [coiling/clipping/both/conservative], complications [vasospasm and hydrocephalus], length of stay, and modified Rankin Scale score at 3 months). Results The female patients with aSAH were older than the male patients (mean age 56.6 vs 51.9 years, respectively, p < 0.001), and more women than men were ≥ 55 years old (56.2% vs 40.4%, respectively, p < 0.001). Women exhibited higher rates of bilateral (6.8% vs 2.6%, respectively, p < 0.05), multiple (11.5% vs 5.2%, respectively, p < 0.05), and internal carotid artery (ICA) (36.9% vs 17.5%, respectively, p < 0.001) aneurysms and a lower rate of anterior cerebral artery aneurysms (26.3% vs 44.8%, respectively, p < 0.001) than the men, but no side differences were noted. There were no sex differences in risk factors, admission-related factors, or outcome measures. For both sexes, outcomes varied according to aneurysm location, with odds ratios for a poor outcome of 1.62 (95% CI 0.91–2.86, p = 0.1) for middle cerebral artery, 2.41 (95% CI 1.29–4.51, p = 0.01) for ICA, and 2.41 (95% CI 1.29–4.51, p = 0.006) for posterior circulation aneurysms compared with those for anterior cerebral artery aneurysms. The odds ratio for poor outcome (modified Rankin Scale score of 4–6) in women compared with men after adjusting for significant prognostic factors was 0.71 (95% CI 0.45–1.11, p > 0.05). Conclusions The overall outcomes after aSAH between women and men are similar.

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Health-Related Quality of Life in Patients with Subarachnoid Haemorrhage

Cited by 66 publications

References 77 publications

Clinical assessment of deficits after SAH: hasty neurosurgeons and accurate neurologists

Clinical assessment of deficits after SAH: hasty neurosurgeons and accurate neurologists

Call for uniform neuropsychological assessment after aneurysmal subarachnoid hemorrhage: Swiss recommendations

Subarachnoid hemorrhage and the female sex: analysis of risk factors, aneurysm characteristics, and outcomes

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