Recovery and rehabilitation following subarachnoid haemorrhage: Part II. Long-term follow-up.

BACKGROUND AND PURPOSE

Subarachnoid haemorrhage (SAH) accounts for 5-10% of all strokes, strikes at a mean age of 50 years and results in a pattern of deficits similar to that of traumatic brain injury. This study is an extension of a previous study which described outcome at discharge from inpatient rehabilitation. The purpose of this follow-up study was to describe long-term functional, cognitive and psychosocial outcome in a cohort of SAH survivors who received inpatient rehabilitation.

METHODS

Subjects were interviewed by telephone. Functional status was assessed using the Functional Independence Measure (FIM) and cognitive status with the Telephone Interview for Cognitive Status (TICS). Social function was determined via a brief questionnaire.

RESULTS

Thirty two out of 80 subjects who received inpatient rehabilitation participated in the study. The 32 did not differ from the original group of 80 on any demographic or clinical criteria. The mean time from onset of SAH to follow-up was 28 months. Total FIM scores improved significantly between discharge and follow up (p < 0.0001) and most subjects functioned at a physically independent level. However, almost 40% scored in the cognitively impaired range on the TICS. Between 40% and 50% required help with common household activities, and none returned to full-time work. Functional and cognitive outcome was not related to any demographic or clinical characteristics at SAH onset.

CONCLUSION

The majority of SAH survivors who received inpatient rehabilitation attain physical independence, but many continue to have cognitive impairments which result in social and vocational disabilities.