Pala Andrej, Pawlikowski Alexandra, Brand Christine, Schmitz Bernd, Wirtz Christian Rainer, König Ralph, Kapapa Thomas
Department of Neurosurgery, University of Ulm, Bezirkskrankenhaus Günzburg, Günzburg, Germany.
Department of Neurosurgery, University of Ulm, Bezirkskrankenhaus Günzburg, Günzburg, Germany.
World Neurosurg. 2019 Jan;121:e54-e59. doi: 10.1016/j.wneu.2018.09.010. Epub 2018 Sep 20.
Quality of life is an important factor in the decision making for the treatment of unruptured intracranial aneurysms (UIA). The data dealing with QoL in patients after the treatment are spare. We have evaluated QoL of patients after endovascular or surgical treatment of incidental intracranial aneurysm.
We performed a prospective analysis of retrospectively collected data. All patients received 36-Item Short Form Health Survey (SF-36), Hospital Anxiety and Depression Scale (HADS), German questionnaire for self-perceived deficits in attention (FEDA) and not standardized questionnaire analyzing personal job-related situation, family circumstances and chronic illnesses.
177 patients were treated during the evaluated period. 79 (44.6%) patients responded. In this cohort, 62.03% of patients underwent coiling. Complications were noted in 13.9% of patients. Stroke was the most common complication (7.6%). All SF-36 related data except for pain showed significant lower mean, if compared to the standard German population (p < 0.01). For both genders, anxiety (males, P = 0.003 and females, P = 0.002) but not depression was more common than in the standard population. According to the FEDA test, treated patients showed significant difference only for fatigue in comparison to healthy population (P < 0.001). 54.4% of patients suffered from chronic illnesses, and among them only 1 patient (1.3%) had aneurysm associated chronic disease. No significant differences were found between treatment modalities.
The risk for depression and pain is not significantly increased after elective treatment of UIA. According to our results, decreased QoL is common in this cohort of patients but often related to factors not associated with aneurysm treatment.
生活质量是未破裂颅内动脉瘤(UIA)治疗决策中的一个重要因素。关于治疗后患者生活质量的数据较少。我们评估了偶然发现的颅内动脉瘤患者接受血管内或手术治疗后的生活质量。
我们对回顾性收集的数据进行了前瞻性分析。所有患者均接受了36项简短健康调查(SF - 36)、医院焦虑抑郁量表(HADS)、德国注意力自我感知缺陷问卷(FEDA)以及一份分析个人工作相关情况、家庭状况和慢性病的非标准化问卷。
在评估期间,177例患者接受了治疗。79例(44.6%)患者进行了回应。在该队列中,62.03%的患者接受了血管内栓塞治疗。13.9%的患者出现了并发症。卒中是最常见的并发症(7.6%)。与德国标准人群相比,除疼痛外,所有SF - 36相关数据的平均得分均显著降低(p < 0.01)。对于男性和女性,焦虑(男性,P = 0.003;女性,P = 0.002)比标准人群更为常见,但抑郁情况并非如此。根据FEDA测试,与健康人群相比,接受治疗的患者仅在疲劳方面存在显著差异(P < 0.001)。54.4%的患者患有慢性病,其中只有1例(1.3%)患有与动脉瘤相关的慢性病。不同治疗方式之间未发现显著差异。
UIA择期治疗后抑郁和疼痛风险未显著增加。根据我们的结果,该队列患者生活质量下降较为常见,但通常与动脉瘤治疗无关的因素有关。