Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland.
Acta Neurochir (Wien). 2012 Aug;154(8):1437-46. doi: 10.1007/s00701-012-1417-y. Epub 2012 Jun 27.
Aneurysmal subarachnoid hemorrhage (SAH) causes long-term psychosocial impairments even in patients who regain functional independence. Little is known about predictors of these impairments. We studied how early clinical data and neuropsychological results predict work status and health-related quality of life (HRQoL) 9-13 years after SAH.
One hundred one patients performed a neuropsychological test battery and returned their self-rating and partner's rating of a psychosocial impairment questionnaire approximately 1 year after SAH. These data were analyzed for association to the patients' work status and self-rated HRQoL approximately 10 years later.
Age inversely, lower levels of self-rated impairments, employment and higher levels of education at the first follow-up independently predicted employment at the long-term follow-up. Although most cognitive test results were significantly associated with employment status at the long-term follow-up, they were of limited additional value as predictors of work status. The best predictor combination for long-term high HRQoL was good performance in a face recognition test and lower levels of self-rated impairments at the first follow-up as well as male sex. Problems in usual activities at the long-term follow-up were predicted by poor results in the face recognition and in a word list-learning task.
Questionnaire ratings of patients' psychosocial impairments 1 year after SAH give important information for the long-term prediction of their work status and HRQoL. In the long run, patients' unemployment becomes strongly associated with higher age, while their performance of usual activities can be predicted with learning and memory results.
即使在患者恢复功能独立性的情况下,动脉瘤性蛛网膜下腔出血(SAH)也会导致长期的社会心理障碍。目前对于这些障碍的预测因素知之甚少。我们研究了早期临床数据和神经心理学结果如何预测 SAH 后 9-13 年的工作状态和健康相关生活质量(HRQoL)。
101 例患者进行了神经心理学测试,大约在 SAH 后 1 年返回自我评估和伴侣对社会心理障碍问卷的评估。这些数据与大约 10 年后患者的工作状态和自我评估的 HRQoL 进行了分析。
年龄呈负相关,自我评估的损伤程度较低、就业和更高的教育水平在第一次随访时独立预测了长期随访时的就业情况。尽管大多数认知测试结果与长期随访时的就业状况显著相关,但作为就业状况的预测指标,其价值有限。预测长期 HRQoL 较高的最佳预测组合是在第一次随访时表现良好的面部识别测试和较低的自我评估损伤程度以及男性。在长期随访中,通常活动中的问题由面部识别和单词列表学习任务中的较差结果预测。
SAH 后 1 年患者社会心理障碍的问卷评分可提供有关其工作状态和 HRQoL 长期预测的重要信息。从长远来看,患者的失业与较高的年龄密切相关,而他们的日常活动表现可以通过学习和记忆结果来预测。