Department of Neurosurgery, Klinikum rechts der Isar, Technical University Munich, Rudolf-Bultmannstrasse 8, Munich, Germany.
Cerebrovasc Dis. 2010;30(4):423-31. doi: 10.1159/000317078. Epub 2010 Aug 18.
Aneurysmal subarachnoid haemorrhage (SAH) is a devastating disease with high mortality and disability. The data from large longitudinal studies on health-related quality of life (HRQoL) in patients with SAH are limited. The objective was to investigate HRQoL in patients after SAH and to identify predictors of HRQoL.
113 patients with aneurysmal SAH were assigned to either neurosurgery (n = 57) or endovascular coiling (n = 56). Clinical assessments (Barthel Index, modified Rankin Scale) and evaluation of HRQoL [36-Item Short-Form Survey, EuroQol (EQ5D), EQ visual analogue scale (EQ VAS)] were performed at discharge, and at 6 and 12 months of follow-up. Independent predictors of HRQoL were determined using multiple regression analysis.
HRQoL in SAH patients was considerably reduced compared to the normal population. At discharge, 92.2% of the patients had moderate or severe problems on the EQ5D. The EQ VAS score was 57.8 +/- 19.3. However, HRQoL still showed improvement from 3 months up to 1 year. At 12 months after SAH, the EQ VAS score was approximately 12-14% higher than at discharge. The independent predictors of decreased HRQoL included female gender, severe SAH, functional disability, depression, a lower level of education and the lack of a stable partnership.
The long-term HRQoL outcome after SAH is unfavourable. HRQoL outcome measures should be included in future studies to provide better evidence of the long-term outcomes after SAH. In addition, the independent determinants of HRQoL identified in this study should be considered in the healthcare programmes aimed at increasing the HRQoL in SAH survivors.
蛛网膜下腔出血(SAH)是一种死亡率和致残率都很高的破坏性疾病。目前关于 SAH 患者健康相关生活质量(HRQoL)的大型纵向研究数据有限。本研究旨在调查 SAH 后患者的 HRQoL,并确定其 HRQoL 的预测因素。
将 113 例蛛网膜下腔出血患者分为神经外科组(n=57)和血管内介入治疗组(n=56)。在出院时和随访 6 个月及 12 个月时,分别对患者进行临床评估(巴氏指数、改良 Rankin 量表)和 HRQoL 评估[36 项简明健康状况调查问卷(SF-36)、欧洲五维健康量表(EQ-5D)、EQ 视觉模拟量表(EQ VAS)]。采用多元回归分析确定 HRQoL 的独立预测因素。
与正常人群相比,SAH 患者的 HRQoL 明显下降。出院时,92.2%的患者在 EQ-5D 上存在中度或重度问题,EQ VAS 评分为 57.8±19.3。然而,从 3 个月到 1 年,HRQoL 仍在不断改善。SAH 后 12 个月,EQ VAS 评分比出院时高约 12-14%。HRQoL 下降的独立预测因素包括女性、严重的 SAH、功能障碍、抑郁、受教育程度较低和缺乏稳定的伴侣关系。
SAH 后患者的长期 HRQoL 结局不佳。未来的研究应纳入 HRQoL 结局测量,以提供更多关于 SAH 后长期结局的证据。此外,本研究确定的 HRQoL 的独立决定因素应在旨在提高 SAH 幸存者 HRQoL 的医疗保健计划中得到考虑。