One-year outcome and quality of life of patients with subarachnoid hemorrhage admitted to intensive care unit: a single-center retrospective pilot study.

Bergamini Carlo, Brogi Etrusca, Salvigni Sara, Romoli Michele, Bini Giovanni, Venditto Alessandra, Lafe Elvis, D'Andrea Marcello, Tosatto Luigino, Ruggiero Maria, Agnoletti Vanni, Russo Emanuele
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Abstract

Patients admitted to intensive care unit (ICU) after non-traumatic subarachnoid hemorrhage (SAH) represent a group with distinctive characteristics and few data are available on long-term outcome in this population. We conducted a single-center retrospective study in an Italian intensive care unit. All patients with non-traumatic SAH (ICD-9-CM Diagnosis Code 430) admitted to ICU were included. Disability and quality of life were evaluated via telephone interview after 12-15 months after initial bleeding using GOSE and EuroQoL, respectively. Baseline and clinical course characteristics were analyzed to evaluate relation with poor outcome defined as GOSE ≤ 3. Final population consisted of 38 patients. Twenty-four patients (63.2%) had favorable outcome (GOSE ≥ 4). Among 29 patients (76.3%) who survived at 1 year, median EQ-5D Index was 0.743 (IQR 0.287), while median EQ-VAS was 74.79 (IQR 18.5). Median EQ-5D Index and median EQ-VAS were higher among patients with favorable outcome (EQ-5D Index p = 0.037, EQ-VAS p = 0.003). Among baseline characteristics, only HH scale showed a significant relation with disability at one year (p = 0.033). Between complications occurred during ICU-stay only early HICP was related with unfavorable outcome (p = 0.028). Higher HH scale and early HICP were related with unfavorable outcome. Among patients with unfavorable outcome, quality of life has a broad range of variability, and this result should be taken into account when reporting patient-centered outcomes.

重症监护室蛛网膜下腔出血患者的一年预后和生活质量:一项单中心回顾性试点研究。
非创伤性蛛网膜下腔出血(SAH)后入住重症监护病房(ICU)的患者代表了一个具有独特特征的群体,很少有关于该人群长期预后的数据。我们在意大利重症监护病房进行了一项单中心回顾性研究。所有非创伤性SAH (ICD-9-CM诊断代码430)患者均纳入ICU。首次出血后12-15个月,通过电话访谈分别使用GOSE和EuroQoL评估残疾和生活质量。分析基线和临床病程特征,以评价与不良预后(定义为GOSE≤3)的关系。最终人群包括38名患者。24例(63.2%)患者预后良好(GOSE≥4)。29例(76.3%)患者1年生存率,中位EQ-5D指数为0.743 (IQR 0.287),中位EQ-VAS为74.79 (IQR 18.5)。预后良好的患者中位EQ-5D指数和中位EQ-VAS较高(EQ-5D指数p = 0.037, EQ-VAS p = 0.003)。在基线特征中,只有HH量表与1年时的残疾有显著关系(p = 0.033)。在icu住院期间发生的并发症中,只有早期HICP与不良预后相关(p = 0.028)。高HH量表和早期HICP与不良预后相关。在预后不良的患者中,生活质量具有广泛的可变性,在报告以患者为中心的预后时应考虑到这一结果。
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