title: Comparison of cohorts of elective and emergency neurosurgical patients: psychosocial outcomes of acoustic neuroma and aneurysmal sub arachnoid hemorrhage patients and carers.
abstract: OBJECTIVE
  To compare the psychosocial outcomes of cohorts of elective [Acoustic Neuroma (AN)] and emergency [Aneu-rysmal Sub Arachnoid Hemorrhage (ASAH)] Neurosurgical patients and carers.
  
  
  METHODS
  The standardized Wessex Patient Carer Questionnaire was designed with patients and carers and provided psychosocial and economic outcome data following elective or emergency surgery. Clinical data on size of tumor and size of bleed, respectively, were extracted from Consultant notes.
  
  
  RESULTS
  Both cohorts were generally satisfied with neurosurgical in-patient care but both suffered high-economic costs and were predominately very dissatisfied with community care. There were significant psychosocial differences between elective and emergency patients, and despite greater relative physical disability among elective patients, it was the emergency cohort who had worse psychosocial outcomes.
  
  
  CONCLUSIONS
  Despite many common psychosocial features, the differences between the cohorts were mainly psychological rather than physiological, because of greater 'post-traumatic-stress-reaction' in the emergency cohort, indicating the need for appropriate psychosocial care immediately after neurosurgery to reduce unnecessary distress and costs to patients, carers, and community.
authors.affiliation: Bournemouth University, Institute of Health and Community Studies, Bournemouth, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Pritchard
authors.forename: Lorraine
authors.initials: L
authors.lastname: Clapham
authors.forename: Lesley
authors.initials: L
authors.lastname: Foulkes
authors.forename: Dorothy A
authors.initials: DA
authors.lastname: Lang
authors.forename: Glenn
authors.initials: G
authors.lastname: Neil-Dwyer
mesh_terms: D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D017558:Elective Surgical Procedures / Q000523:psychology*; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009464:Neuroma, Acoustic / Q000191:economics / Q000523:psychology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000523:psychology*; D010351:Patient Discharge; D017060:Patient Satisfaction; D013345:Subarachnoid Hemorrhage / Q000191:economics / Q000523:psychology / Q000601:surgery*; D016896:Treatment Outcome