Self-perceived health status following aneurysmal subarachnoid haemorrhage: a cohort study.
OBJECTIVE
The objective of the study was to assess the long-term self-reported health status and quality of life (QoL) of patients following an aneurysmal subarachnoid haemorrhage (ASAH) using a self-completed questionnaire booklet.


METHODS
A two-cohort study.


METHODS
A regional tertiary neurosurgical centre.


METHODS
2 cohorts of patients with ASAH treated between 1998 and 2008 and followed up at approximately 1 year.


METHODS
Routine care.


METHODS
A range of standardised scales included: AKC Short Sentences Test, the Barthel Index, the Self-Report Dysexecutive Questionnaire, the Everyday Memory Questionnaire, Stroke Symptom Checklist, Wimbledon Self-Report Scale, Modified Rankin Score (MRS) and a new Stroke-QoL. The data from summated scales were fit to the Rasch measurement model to validate the summed score.


RESULTS
214 patients (48%) returned the questionnaires; the majority (76%) had a World Federation of Neurosurgeons grade of 1 or 2. The most frequent aneurysm type was that of the anterior communicating artery (28%) with approximately 90% of aneurysms of the anterior circulation. Of those previously in full or part-time employment, 48.9% were unemployed at follow-up. All summated scales satisfied the Rasch measurement model requirements, such that their summed scores were a sufficient statistic. Given this, one-third of patients were noted to have a significant mood disorder and 25% had significant dysexecutive function. Patients with an MRS of 3, 4 or 5 had significantly worse scores on most outcome measures, but a significant minority of those with a score of zero had failed to return to work and displayed significant mood disorder.


CONCLUSIONS
A range of self-reported cognitive and physical deficits have been highlighted in a cohort of patients with ASAH. While the MRS has been shown to provide a reasonable indication of outcome, in routine clinical follow-up it requires supplementation by instruments assessing dysexecutive function, memory and mood.
Department of Anaesthesia, Leeds General Infirmary, Leeds, UK.
Audrey C
AC
Quinn
Deepti
D
Bhargava
Yahia Z
YZ
Al-Tamimi
Matthew J
MJ
Clark
Stuart A
SA
Ross
Alan
A
Tennant
D056344:Executive Function; D005260:Female; D006304:Health Status; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011788:Quality of Life; D062707:Return to Work / Q000706:statistics & numerical data; D057566:Self Report; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000523:psychology; D011795:Surveys and Questionnaires
Stroke Medicine