Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Anaesthesiology and Intensive Care, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Acta Neurol Scand. 2022 Nov;146(5):525-536. doi: 10.1111/ane.13674. Epub 2022 Jul 18.
The survival rates for patients affected by aneurysmal subarachnoid hemorrhage (aSAH) have increased in recent years; however, many patients continue to develop cognitive dysfunctions that affect their quality of life. The commonly used outcome measures often fail to identify these cognitive dysfunctions. This study aimed to evaluate the long-term outcomes at 1 and 3 years after aSAH to assess changes over time and relate outcomes to patient characteristics and events during the acute phase.
This prospective observational study included patients that experienced aSAH. Patients were assessed according to the extended Glasgow Outcome Scale, Life Satisfaction Questionnaire, Mayo-Portland Adaptability inventory-4, and Mental Fatigue scale.
Patients were assessed after 1 year (n = 62) and 3 years (n = 54). At 3 years, the extended Glasgow Outcome Scale score improved in 15% and worsened in 12% of the patients. Mental fatigue was observed in 57% of the patients at 1 year. Patients <60 years of age at the time of aSAH had more self-assessed problems, including pain/headache (p < .01), than patients >60 years of age. Patients with delayed cerebral ischemia during the acute phase reported more dissatisfaction at 3 years, whereas no significant result was seen at 1 year.
Cognitive dysfunction, especially mental fatigue, is common in patients with aSAH, which affects quality of life and recovery. Patient outcome is a dynamic process developing throughout years after aSAH, involving both improvement and deterioration. This study indicates the importance of longer follow-up periods with broad outcome assessments.
近年来，患有颅内动脉瘤性蛛网膜下腔出血（aSAH）的患者的生存率有所提高；然而，许多患者仍会出现认知功能障碍，影响其生活质量。常用的结局评估方法往往无法识别这些认知功能障碍。本研究旨在评估 aSAH 后 1 年和 3 年的长期结局，以评估随时间的变化，并将结局与患者特征和急性期事件相关联。
本前瞻性观察研究纳入了患有 aSAH 的患者。根据格拉斯哥预后扩展量表、生活满意度问卷、梅奥-波特兰适应能力量表-4 和精神疲劳量表对患者进行评估。
患者在 1 年后（n=62）和 3 年后（n=54）进行了评估。在 3 年后，15%的患者格拉斯哥预后扩展量表评分改善，12%的患者评分恶化。1 年后，57%的患者出现精神疲劳。aSAH 时年龄<60 岁的患者自我评估的问题（包括疼痛/头痛）比年龄>60 岁的患者更多（p<0.01）。急性期发生迟发性脑缺血的患者在 3 年后报告的不满更多，而在 1 年后则没有显著结果。
认知功能障碍，特别是精神疲劳，在 aSAH 患者中很常见，这会影响生活质量和恢复。患者结局是一个动态过程，在 aSAH 后多年发展，涉及改善和恶化。本研究表明，需要进行更长时间的随访和更广泛的结局评估。
