Health-related quality of life in patients with subarachnoid haemorrhage.
BACKGROUND
Aneurysmal subarachnoid haemorrhage (SAH) is a devastating disease with high mortality and disability. The data from large longitudinal studies on health-related quality of life (HRQoL) in patients with SAH are limited. The objective was to investigate HRQoL in patients after SAH and to identify predictors of HRQoL.


METHODS
113 patients with aneurysmal SAH were assigned to either neurosurgery (n = 57) or endovascular coiling (n = 56). Clinical assessments (Barthel Index, modified Rankin Scale) and evaluation of HRQoL [36-Item Short-Form Survey, EuroQol (EQ5D), EQ visual analogue scale (EQ VAS)] were performed at discharge, and at 6 and 12 months of follow-up. Independent predictors of HRQoL were determined using multiple regression analysis.


RESULTS
HRQoL in SAH patients was considerably reduced compared to the normal population. At discharge, 92.2% of the patients had moderate or severe problems on the EQ5D. The EQ VAS score was 57.8 +/- 19.3. However, HRQoL still showed improvement from 3 months up to 1 year. At 12 months after SAH, the EQ VAS score was approximately 12-14% higher than at discharge. The independent predictors of decreased HRQoL included female gender, severe SAH, functional disability, depression, a lower level of education and the lack of a stable partnership.


CONCLUSIONS
The long-term HRQoL outcome after SAH is unfavourable. HRQoL outcome measures should be included in future studies to provide better evidence of the long-term outcomes after SAH. In addition, the independent determinants of HRQoL identified in this study should be considered in the healthcare programmes aimed at increasing the HRQoL in SAH survivors.
Meyer
Bernhard
B
Department of Neurosurgery, Klinikum rechts der Isar, Technical University Munich, Rudolf-Bultmannstrasse 8, Munich, Germany.
Ringel
Florian
F
Winter
Yaroslav
Y
Spottke
Annika
A
Gharevi
Nadir
N
Dams
Judith
J
Balzer-Geldsetzer
Monika
M
Mueller
Ines K
IK
Klockgether
Thomas
T
Schramm
Johannes
J
Urbach
Horst
H
Dodel
Richard
R
D000328:Adult; D000368:Aged; D003863:Depression / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery