title: Dichotomous "Good Outcome" Indicates Mobility More Than Cognitive or Social Quality of Life.
abstract: OBJECTIVE
  Worthwhile interventions for intracerebral hemorrhage or subarachnoid hemorrhage generally hinge on whether they improve the odds of good outcome. Although good outcome is correlated with mobility, correlations with other domains of health-related quality of life, such as cognitive function and social functioning, are not well described. We tested the hypothesis that good outcome is more closely associated with mobility than other domains.
  
  
  METHODS
  We defined "good outcome" as 0 through 3 (independent ambulation or better) versus 4 through 5 (dependent) on the modified Rankin Scale at 1, 3, and 12 months. We simultaneously assessed the modified Rankin Scale and health-related quality of life using web-based computer adaptive testing in the domains of mobility, cognitive function (executive function and general concerns), and satisfaction with social roles and activities. We compared the area under the curve between different health-related quality of life domains.
  
  
  METHODS
  Neurologic ICU with web-based follow-up.
  
  
  METHODS
  One hundred fourteen patients with subarachnoid hemorrhage or intracerebral hemorrhage.
  
  
  METHODS
  None.
  
  
  RESULTS
  We longitudinally followed 114 survivors with data at 1 month, 62 patients at 3 months, and 58 patients at 12 months. At 1 month, area under the curve was highest for mobility (0.957; 95% CI, 0.904-0.98), higher than cognitive function-general concerns (0.819; 95% CI, 0.715-0.888; p = 0.003 compared with mobility), satisfaction with social roles and activities (0.85; 95% CI, 0.753-0.911; p = 0.01 compared with mobility), and cognitive function-executive function (0.879; 95% CI, 0.782-0.935; p = 0.058 compared with mobility). Optimal specificity and sensitivity for receiver operating characteristic analysis were approximately 1.5 SD below the U.S. population mean.
  
  
  CONCLUSIONS
  Health-related quality of life assessments reliably distinguished between good and poor outcomes as determined by the modified Rankin Scale. Good outcome indicated health-related quality of life about 1.5 SD below the U.S. population mean. Associations were weaker for cognitive function and social function than mobility.
authors.affiliation: 1Department of Neurology, Northwestern University, Chicago, IL. 2Departent of Medical Social Sciences, Northwestern University, Chicago, IL. 3Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University, Chicago, IL.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Naidech
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Beaumont
authors.forename: Michael
authors.initials: M
authors.lastname: Berman
authors.forename: Brandon
authors.initials: B
authors.lastname: Francis
authors.forename: Eric
authors.initials: E
authors.lastname: Liotta
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Maas
authors.forename: Shyam
authors.initials: S
authors.lastname: Prabhakaran
authors.forename: Jane
authors.initials: J
authors.lastname: Holl
authors.forename: David
authors.initials: D
authors.lastname: Cella
mesh_terms: D000328:Adult; D000368:Aged; D002543:Cerebral Hemorrhage / Q000523:psychology* / Q000534:rehabilitation; D003071:Cognition; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010549:Personal Satisfaction; D011788:Quality of Life / Q000523:psychology*; D013345:Subarachnoid Hemorrhage / Q000523:psychology* / Q000534:rehabilitation