Schöni Daniel, Lauber Lara, Fung Christian, Goldberg Johannes, Müri René, Raabe Andreas, Nyffeler Thomas, Beck Jürgen
Department of Neurosurgery, Bern University Hospital, Bern, Switzerland.
Department of Neurosurgery, Bern University Hospital, Bern, Switzerland.
World Neurosurg. 2018 May;113:e161-e165. doi: 10.1016/j.wneu.2018.01.205. Epub 2018 Feb 6.
Common sequelae of subarachnoid hemorrhage (SAH) include somatic and/or cognitive impairment. This can cause emotional stress, social tensions, and difficulties in relationships. To test our hypothesis that more severe somatic and cognitive impairments increased the likelihood of disruption of a relationship after SAH, we assessed the integrity of marriage or partnership status in a well-evaluated subset of SAH patients.
Our sample comprised 50 SAH patients who were discharged to a neurologic, in-house rehabilitation center between 2005 and 2010. Deficits on admission to the rehabilitation center were divided into 18 categories and grouped into minor and major somatic deficits, as well as cognitive deficits. Clinical outcome scores, marital/partnership status, and duration of partnership before ictus were recorded. A follow-up questionnaire after 4.3 (2012) and 8.8 (2017) years was used to assess changes in marital/partnership status. Possible predictor parameters were estimated and included in a stepdown regression analysis.
In 2012, after a mean follow-up of 4.3 years, 8 of the 50 SAH patients were divorced or separated, whereas after 8.8 years only 1 additional relationship had ended. In our regression model analysis, a "short duration of relationship" before SAH and the presence of a "few minor somatic deficits" were associated with a higher likelihood of divorce or separation in the near future and remained unchanged at long-term follow-up.
Contrary to our hypothesis, neither the presence of severe somatic or cognitive deficits nor clinical evaluation scores reliably predicted divorce or separation after SAH.
蛛网膜下腔出血(SAH)的常见后遗症包括躯体和/或认知障碍。这可能导致情绪压力、社会关系紧张及人际关系困难。为验证我们的假设,即更严重的躯体和认知障碍会增加SAH后关系破裂的可能性,我们评估了一组经过充分评估的SAH患者的婚姻或伴侣关系状况。
我们的样本包括2005年至2010年间出院至内部神经康复中心的50例SAH患者。康复中心入院时的缺陷分为18类,并分为轻度和重度躯体缺陷以及认知缺陷。记录临床结局评分、婚姻/伴侣关系状况以及发病前伴侣关系的持续时间。在4.3年(2012年)和8.8年(2017年)后使用随访问卷评估婚姻/伴侣关系状况的变化。估计可能的预测参数并将其纳入逐步回归分析。
2012年,平均随访4.3年后,50例SAH患者中有8例离婚或分居,而8.8年后仅又有1段关系结束。在我们的回归模型分析中,SAH前“伴侣关系持续时间短”和存在“一些轻度躯体缺陷”与近期离婚或分居的可能性较高相关,并且在长期随访中保持不变。
与我们的假设相反,严重躯体或认知缺陷的存在以及临床评估评分均不能可靠地预测SAH后的离婚或分居。