title: Cognitive domain deficits in patients with aneurysmal subarachnoid haemorrhage at 1 year.
abstract: BACKGROUND
  Cognitive domain deficits can occur after aneurysmal subarachnoid haemorrhage (aSAH) though few studies systemically evaluate its impact on 1-year outcomes.
  
  
  OBJECTIVE
  We aimed to evaluate the pattern and functional outcome impact of cognitive domain deficits in aSAH patients at 1 year.
  
  
  METHODS
  We carried out a prospective observational study in Hong Kong, during which, 168 aSAH patients (aged 21-75 years and had been admitted within 96 h of ictus) were recruited over a 26-month period. The cognitive function was assessed by a domain-specific neuropsychological assessment battery at 1 year after ictus. The current study is registered at ClinicalTrials.gov of the US National Institutes of Health (NCT01038193).
  
  
  RESULTS
  Prevalence of individual domain deficits varied between 7% to 15%, and 13% had two or more domain deficits. After adjusting for abbreviated National Institute of Health Stroke Scale and Geriatric Depressive Scale scores, unfavourable outcome (Modified Rankin Scale 3-5) and dependent instrumental activity of daily living (Lawton Instrumental Activity of Daily Living<15) were significantly associated with two or more domain deficits and number of cognitive domain deficits at 1 year. Two or more domain deficits was independently associated with age (OR, 1.1; 95% CI 1.1 to 1.2; p<0.001) and delayed cerebral infarction (OR, 6.1; 95% CI 1.1 to 33.5; p=0.036), after adjustment for years of school education.
  
  
  CONCLUSIONS
  In patients with aSAH, cognitive domain deficits worsened functional outcomes at 1 year. Delayed cerebral infarction was an independent risk factor for two or more domain deficits at 1 year.
authors.affiliation: Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong. georgewong@surgery.cuhk.edu.hk
authors.forename: George Kwok Chu
authors.initials: GK
authors.lastname: Wong
authors.forename: Sandy Wai
authors.initials: SW
authors.lastname: Lam
authors.forename: Karine
authors.initials: K
authors.lastname: Ngai
authors.forename: Adrian
authors.initials: A
authors.lastname: Wong
authors.forename: Deyond
authors.initials: D
authors.lastname: Siu
authors.forename: Wai Sang
authors.initials: WS
authors.lastname: Poon
authors.forename: Vincent
authors.initials: V
authors.lastname: Mok
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000523:psychology; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology*; D015331:Cohort Studies; D003863:Depression / Q000209:etiology / Q000523:psychology; D056344:Executive Function; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011597:Psychomotor Performance; D012307:Risk Factors; D020521:Stroke / Q000523:psychology; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000523:psychology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult