Wouter J Dronkers, Menno R Germans, René Post, Bert A Coert, Jonathan M Coutinho, René van den Berg, William Peter Vandertop, Dagmar Verbaan
{"title":"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。","authors":"Wouter J Dronkers, Menno R Germans, René Post, Bert A Coert, Jonathan M Coutinho, René van den Berg, William Peter Vandertop, Dagmar Verbaan","doi":"10.1177/23969873251362012","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Patients and methods: </strong>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.</p><p><strong>Results: </strong>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, <i>p</i> = 0.036). Furthermore, PMSAH patients were more likely to fully return to work (<i>p</i> = 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 (<i>n</i> = 164; 68%), increased concentration difficulties (<i>n</i> = 130; 54%), and increased forgetfulness (<i>n</i> = 121; 50%) were the most frequently reported residual symptoms.</p><p><strong>Discussion and conclusion: </strong>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.</p>","PeriodicalId":46821,"journal":{"name":"European Stroke Journal","volume":" ","pages":"23969873251362012"},"PeriodicalIF":4.5000,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350299/pdf/","citationCount":"0","resultStr":"{\"title\":\"Functional outcome, return to work and quality of life in patients with non-aneurysmal subarachnoid hemorrhage.\",\"authors\":\"Wouter J Dronkers, Menno R Germans, René Post, Bert A Coert, Jonathan M Coutinho, René van den Berg, William Peter Vandertop, Dagmar Verbaan\",\"doi\":\"10.1177/23969873251362012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Patients and methods: </strong>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.</p><p><strong>Results: </strong>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, <i>p</i> = 0.036). Furthermore, PMSAH patients were more likely to fully return to work (<i>p</i> = 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 (<i>n</i> = 164; 68%), increased concentration difficulties (<i>n</i> = 130; 54%), and increased forgetfulness (<i>n</i> = 121; 50%) were the most frequently reported residual symptoms.</p><p><strong>Discussion and conclusion: </strong>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.</p>\",\"PeriodicalId\":46821,\"journal\":{\"name\":\"European Stroke Journal\",\"volume\":\" \",\"pages\":\"23969873251362012\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2025-08-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350299/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Stroke Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/23969873251362012\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Stroke Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/23969873251362012","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Functional outcome, return to work and quality of life in patients with non-aneurysmal subarachnoid hemorrhage.
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.
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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