Functional outcome, return to work and quality of life in patients with non-aneurysmal subarachnoid hemorrhage.

IF 4.5 3区 医学 Q1 CLINICAL NEUROLOGY
Wouter J Dronkers, Menno R Germans, René Post, Bert A Coert, Jonathan M Coutinho, René van den Berg, William Peter Vandertop, Dagmar Verbaan
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引用次数: 0

Abstract

Introduction: Non-aneurysmal, non-traumatic subarachnoid hemorrhage (nSAH) refers to cases where a causative aneurysm cannot be identified. We studied 6-months' outcomes in nSAH patients.

Patients and methods: From a prospective SAH registry of all nSAH patients admitted between 2012 and 2023, relevant complications and outcomes were collected. Functional outcome and return-to-work at 6 months were assessed using the modified Rankin Scale (mRS), quality of life with the EuroQol-5Dimensions (EQ-5D) and Hospital Anxiety and Depression Scale (HADS), and an institutional 14-item questionnaire for assessment of residual symptoms.

Results: 325 consecutive nSAH patients were included (192 non-perimesencephalic, non-aneurysmal subarachnoid hemorrhage (NPSAH); 133 perimesencephalic subarachnoid hemorrhage (PMSAH)). 303 (93%; 180 NPSAH and 123 PMSAH) were available at follow-up (7 patients died). Favorable functional outcome (mRS-score 0-2) was reported in 271 (89%) patients and did not differ between NPSAH- and PMSAH. One hundred forty-one (77%) patients returned to work, whereas only 71 (39%) patients reached their previous level of work. PMSAH patients were more likely to return to work (68/96 (71%) NPSAH and 73/87 (84%) PMSAH, respectively, p = 0.036). Furthermore, PMSAH patients were more likely to fully return to work (p = 0.028). The mean (SD) EQ-5D and EQ-VAS scores were 0.827 (0.184) and 74 (16), respectively. The HADS-A and -D scores were deviant (score > 7 points) in 53 (23%) and 48 (21%) patients, respectively. Only 39 patients (16%) denied experiencing residual symptoms. Increased fatigue (n = 164; 68%), increased concentration difficulties (n = 130; 54%), and increased forgetfulness (n = 121; 50%) were the most frequently reported residual symptoms.

Discussion and conclusion: This study reveals that the majority of nSAH patients reports residual symptoms and did not return to their previous level of work at 6 months follow-up, despite a favorable functional outcome. These findings nuance the perception of a good outcome, as suggested in previous studies, warranting further research on possible rehabilitative interventions and counseling in these patients.

非动脉瘤性蛛网膜下腔出血患者的功能结局、恢复工作和生活质量。
简介:非动脉瘤性、非外伤性蛛网膜下腔出血(nSAH)是指无法确定病因动脉瘤的病例。我们研究了nSAH患者6个月的预后。患者和方法:从2012年至2023年间入院的所有nSAH患者的前瞻性SAH登记中,收集相关并发症和结果。使用改进的Rankin量表(mRS)、生活质量euroqol -5维度(EQ-5D)和医院焦虑和抑郁量表(HADS),以及用于评估剩余症状的14项机构问卷,对6个月时的功能结局和重返工作进行评估。结果:纳入325例连续nSAH患者(192例为非脑周、非动脉瘤性蛛网膜下腔出血(NPSAH);133脑膜周围蛛网膜下腔出血(PMSAH))。303 (93%;随访时有180例NPSAH和123例PMSAH患者(7例死亡)。271例(89%)患者报告了良好的功能预后(mrs评分0-2),NPSAH和PMSAH之间没有差异。141名(77%)患者重返工作岗位,而只有71名(39%)患者达到了之前的工作水平。PMSAH患者更有可能重返工作岗位(NPSAH为68/96 (71%),PMSAH为73/87 (84%),p = 0.036)。此外,PMSAH患者更有可能完全恢复工作(p = 0.028)。平均(SD) EQ-5D和EQ-VAS评分分别为0.827(0.184)和74(16)。HADS-A和d评分偏差(bb07分)的患者分别为53例(23%)和48例(21%)。只有39名患者(16%)否认有残留症状。增加疲劳(n = 164;68%),注意力集中困难增加(n = 130;54%),健忘增加(n = 121;50%)是最常报告的残留症状。讨论和结论:本研究显示,尽管功能预后良好,但大多数nSAH患者在随访6个月后仍报告残留症状,并没有恢复到以前的工作水平。正如之前的研究表明的那样,这些发现细微差别了对良好结果的看法,保证了对这些患者可能的康复干预和咨询的进一步研究。
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来源期刊
CiteScore
7.50
自引率
6.60%
发文量
102
期刊介绍: Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.
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