Department of Neurosurgery, Goethe University Hospital Frankfurt, Schleusenweg 16, 60528, Frankfurt a.M., Germany.
Department of Neurosurgery, University Hospital Rostock, Rostock, Germany.
Neurosurg Rev. 2022 Oct;45(5):3281-3290. doi: 10.1007/s10143-022-01847-8. Epub 2022 Sep 9.
Intracranial haemorrhage (ICH) is associated with permanent neurological disability resulting in deterioration of the quality of life (QoL). Our study assesses QoL in patients with ruptured arteriovenous malformation (AVM) in long-term follow-up at least five years after ICH and compares their QoL with the QoL of patient with non-ruptured AVM.
Using the Quality of Life Scale (QOLS), the Patient Health Questionnaire (PHQ-9) for depressive symptoms, and the socioeconomic status (SES), a prospective assessment was performed. The modified Rankin Scale (mRS) was assessed for outcome.
Of 73 patients, 42 (57.5%) had ruptured (group 1) and 31 (42.5%) a non-ruptured AVM (group 2). Mean follow-up time was 8.6 ± 3.9 years (8.5 ± 4.2 years in group 1 and 8.9 ± 3.7 years in group 2). Favourable outcome (mRS 0-1) was assessed in 60 (83.3%) and unfavourable in 12 (16.7%) patients. Thirty-one of 42 patients (73.8%) in group 1 and 29 of 30 patients in group 2 (96.7%) had favourable outcomes. Mean QOLS was 85.6 ± 14.1 (group 1 86.1 ± 15.9, group 2 84.9 ± 11.4). Patients in group 1 did not show a significant difference in QoL compared to patients in group 2 (p = 0.23). Additional analyses in group 2 (rho = - 0.73; p < 0.01) and in untreated AVM patients (rho = - 0.81; p < 0.01) showed a strong correlation between QOLS and PHQ-9.
Long-term follow-up showed no difference in the QoL between patients with and without ICH caused by brain AVM. Outcome- and QoL-scores were high in both groups. Further studies are necessary to evaluate depression and anxiety symptoms in patients with AVM.
颅内出血（ICH）与永久性神经功能障碍相关，导致生活质量（QoL）恶化。我们的研究评估了至少在 ICH 后五年进行长期随访的破裂动静脉畸形（AVM）患者的 QoL，并将其与未破裂 AVM 患者的 QoL 进行了比较。
使用生活质量量表（QOLS）、患者健康问卷（PHQ-9）评估抑郁症状和社会经济状况（SES），进行前瞻性评估。采用改良Rankin 量表（mRS）评估结局。
73 例患者中，42 例（57.5%）为破裂性（组 1），31 例（42.5%）为非破裂性 AVM（组 2）。平均随访时间为 8.6±3.9 年（组 1 为 8.5±4.2 年，组 2 为 8.9±3.7 年）。60 例（83.3%）患者结局良好（mRS 0-1），12 例（16.7%）患者结局不良。组 1 中 42 例患者中的 31 例（73.8%）和组 2 中 30 例患者中的 29 例（96.7%）结局良好。组 1 的平均 QOLS 为 85.6±14.1（组 1 为 86.1±15.9，组 2 为 84.9±11.4）。与组 2 相比，组 1 患者的 QoL 无显著差异（p=0.23）。组 2 内（rho=−0.73；p<0.01）和未治疗 AVM 患者内（rho=−0.81；p<0.01）的进一步分析显示，QOLS 与 PHQ-9 之间存在强烈相关性。
长期随访显示，ICH 引起的 AVM 患者与未引起 ICH 的患者的 QoL 无差异。两组患者的结局和 QoL 评分均较高。有必要进一步研究 AVM 患者的抑郁和焦虑症状。
