Quality of life with special respect to depression after surgical treatment of hypertensive basal ganglia hemorrhage.
BACKGROUND
Hypertensive intracerebral hemorrhage is associated with high mortality and morbidity. Place of surgery in the primary supratentorial intracerebral hemorrhage is uncertain and the data on the long-term functional outcome of surgery in these patients is limited.


OBJECTIVE
The aim of the study was to determine long-term functional outcome of patients undergoing surgical treatment for hypertensive basal ganglia hemorrhage, especially in respect to depression.


METHODS
Retrospective analysis of database of 44 patients undergoing craniotomy for hypertensive basal ganglia hemorrhage between December 2002 and May 2007.


METHODS
Long-term was defined as at least 18 months after craniotomy. Neurological status of the patients at admission was assessed by National Institute of Health Stroke Scale (NIHSS) and Glasgow Coma Scale (GCS). Outcome data consisted of the items including functionality, depression and quality of life. Tests applied included Barthel Index (BI), modified Rankin Scale (mRS), Beck Depression Inventory (BDI) and stroke-specific quality of life (SSQOL) scale.


RESULTS
The long-term mortality rate was 29.5% (13/44). Of the 31 survivors, 21 (67.7%) patients had a BI >or= 60, 23 (74.2%) patients had a mRS <4 and 21 (67.7%) patients had a SSQOL >or= 60%, each representing a favorable outcome. In retrospect, 19 (61.3%) patients approved the surgery. Eighteen (58.1%) patients developed depression (BDI > 9), which was related to high NIHSS and low GCS score preoperatively, low BI, high mRS and low SSQOL postoperatively.


CONCLUSIONS
The study reveals that depression is a common long-term complication after surgical treatment of hypertensive basal ganglion hemorrhage. Both the NIHSS and GCS scores before operation have critical roles in patient's quality of life associated with depression.
Hai
Jian
J
Department of Neurosurgery, Tongji Hospital, Tong ji University, Shanghai - 200 065, China. haijiandoc@yahoo.com.cn
Zhang
Lin
L
Wang
Fei
F
Wan
Jue-Feng
JF
Pan
Qing-Gang
QG
D000368:Aged; D020145:Basal Ganglia Hemorrhage / Q000150:complications / Q000601:surgery*; D003863:Depression / Q000209:etiology* / Q000523:psychology*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D020299:Intracranial Hemorrhage, Hypertensive / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000503:physiopathology*; D011788:Quality of Life; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods