Kissling Francis J, Goldberg Johannes, Raabe Andreas, Bervini David
Bern University, Bern, Switzerland.
Department of Neurosurgery, Inselspital, Bern University Hospital, Bern, Switzerland.
World Neurosurg X. 2024 Feb 29;22:100305. doi: 10.1016/j.wnsx.2024.100305. eCollection 2024 Apr.
Rupture of intracranial aneurysms is the most frequent cause of subarachnoid hemorrhage and is associated with high morbidity. Recommendations for preventive treatment of unruptured aneurysms (UIAs) remain controversial due to inconsistent data on their natural history and the risks associated with treatment. The awareness of being diagnosed with one or more UIAs can provoke feelings of anxiety and psychosocial distress. Therefore, the impact of management on a patients' health perception and quality of life (QoL) is an essential factor to be considered in the treatment decision-making process.
The aim of this study was to assess and compare QoL in patients diagnosed with one or more UIAs depending on their treatment as well as their pre- or postoperative status.
Demographic and clinical data as well as results of the 15D quality of life (15D QoL) questionnaire of 189 patients were prospectively collected and retrospectively analyzed. Patients were categorized into different subgroups, depending on their treatment modalities (conservative, microsurgery or endovascular treatment) and their pre- or postoperative status at the time of completion of the questionnaire. Statistical analysis was performed to compare the different subgroups.
Conservatively treated patients had similar mean 15D QoL scores as preoperative patients. Despite an initial postoperative QoL reduction and a trend towards recovery and even an improvement of QoL in the long term after UIA occlusion, neither clinically relevant nor statistically significant differences between preoperative and postoperative mean 15D QoL scores were observed.
Health-related QoL does not significantly change after treatment of UIAs when compared to the preoperative period. Further studies are needed to confirm long-term postoperative quality of life changes as well as treatment-related influencing factors on patients' quality of life.
颅内动脉瘤破裂是蛛网膜下腔出血最常见的原因，且发病率高。由于未破裂动脉瘤（UIAs）自然病史及治疗相关风险的数据不一致，其预防性治疗的建议仍存在争议。被诊断患有一个或多个未破裂动脉瘤可能引发焦虑情绪和心理社会困扰。因此，治疗方式对患者健康认知和生活质量（QoL）的影响是治疗决策过程中需考虑的重要因素。
本研究旨在评估和比较根据治疗方式以及术前或术后状态诊断为患有一个或多个未破裂动脉瘤的患者的生活质量。
前瞻性收集并回顾性分析了189例患者的人口统计学和临床数据以及15D生活质量（15D QoL）问卷结果。根据患者的治疗方式（保守治疗、显微手术或血管内治疗）以及问卷完成时的术前或术后状态，将患者分为不同亚组。进行统计分析以比较不同亚组。
保守治疗的患者平均15D QoL评分与术前患者相似。尽管术后初期生活质量有所下降，且有恢复趋势，甚至在未破裂动脉瘤闭塞后的长期内生活质量有所改善，但术前和术后平均15D QoL评分之间未观察到临床相关或统计学上的显著差异。
与术前相比，未破裂动脉瘤治疗后与健康相关的生活质量没有显著变化。需要进一步研究以确认术后长期生活质量的变化以及治疗相关因素对患者生活质量的影响。
