Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, Heidelberglaan 100, 3484 CX, Utrecht, The Netherlands.
J Neurol. 2010 Dec;257(12):2059-64. doi: 10.1007/s00415-010-5660-y. Epub 2010 Jul 22.
Patients who recover from aneurysmal subarachnoid haemorrhage (SAH) often remain disabled or have persisting symptoms with a reduced quality of life (QoL). We assessed functional outcome and QoL 5 and 12.5 years after SAH. In a consecutive series of 64 patients with mean age at SAH of 51 years, initial outcome assessments had been performed at 4 and 18 months after SAH. At the initial and current outcome assessments, functional outcome was measured with the modified Rankin Scale (mRS) and QoL with the SF-36 and a visual analogue scale (VAS). We studied the change in outcome measurements over time. We used the non-parametric Wilcoxon test to compare differences in mRS grades and calculated differences with corresponding 95% confidence intervals in the domain scores of the SF-36 and the VAS. After 5 years, seven patients had died and five patients had missing data. Compared with the 4-month follow-up, the mRS had improved in 29 of the 52 patients, remained similar in 19 patients. The overall QoL (SF-36 domains and VAS score) was better. At 12.5 years an additional six patients had died. Compared to the 4-month study, 25 of the 46 remaining patients had improved mRS, 12 had remained the same and in nine patients the mRS had worsened. Between the 5 and the 12.5 years follow-up, the improvement in mRS had decreased but patients reported overall a better QoL. Among long-time survivors, QoL may improve more than a decade after SAH.
患有脑动脉瘤性蛛网膜下腔出血(SAH)的患者在康复后常常仍然残疾或有持续的症状,生活质量(QoL)降低。我们评估了 SAH 后 5 年和 12.5 年的功能结局和 QoL。在一系列连续的 64 例平均年龄为 51 岁的 SAH 患者中,最初的结局评估分别在 SAH 后 4 个月和 18 个月进行。在最初和当前的结局评估中,使用改良 Rankin 量表(mRS)测量功能结局,使用 SF-36 和视觉模拟量表(VAS)测量 QoL。我们研究了随着时间的推移,结局测量值的变化。我们使用非参数 Wilcoxon 检验比较 mRS 等级的差异,并计算 SF-36 各领域评分和 VAS 的差异及其相应的 95%置信区间。5 年后,7 名患者死亡,5 名患者数据缺失。与 4 个月随访相比,52 例患者中有 29 例 mRS 改善,19 例 mRS 相似。整体 QoL(SF-36 各领域评分和 VAS 评分)更好。12.5 年后,又有 6 名患者死亡。与 4 个月研究相比,46 例剩余患者中有 25 例 mRS 改善,12 例保持不变,9 例 mRS 恶化。在 5 年至 12.5 年的随访期间,mRS 的改善程度有所下降,但患者总体报告 QoL 更好。在长期幸存者中,SAH 后 10 多年 QoL 可能会改善。