title: Reduced Quality of Life in Patients with Pituitary Dysfunction After Aneurysmal Subarachnoid Hemorrhage: A Prospective Longitudinal Study.
abstract: OBJECTIVE
  Pituitary dysfunction (PD) after aneurysmal subarachnoid hemorrhage (SAH) has been demonstrated in several studies. Given the similarities between psychological symptoms and reduced quality of life (QoL) in patients with PD and fatigue commonly seen in patients after SAH, we investigated the relationship between QoL and PD after SAH.
  
  
  METHODS
  There were 51 patients with aneurysmal SAH prospectively recruited and evaluated for health-related QoL using the Psychological General Well-Being Index. Evaluations were conducted 3-6 months (n = 45), 6-12 months (n = 44), and 12-24 months (n = 44) after SAH, with concomitant assessment of endocrine function. The study protocol also included a magnetic resonance imaging examination 3 months after SAH.
  
  
  RESULTS
  Mean general well-being scores showed a positive trend from 97.3 at 3-6 months to 104.3 at 12-24 months for all patients. Multiple regression analysis identified age, sex, Hunt and Hess grade, and PD as independent predictors for general well-being. Patients with PD had significantly lower scores compared with patients with normal pituitary function at 3-6 months (85.4 vs. 101.7) and 6-12 months (90.4 vs. 105.3). This result was due to central hypoadrenalism (score 81.6 at 3-6 months and score 82.2 at 6-12 months) but not other types of PD. The extent of magnetic resonance imaging lesions had a significant negative correlation to Glasgow Outcome Scale score at all follow-up evaluations. All patients with hypothalamic magnetic resonance imaging lesions had evidence of PD at some point during the follow-up period.
  
  
  CONCLUSIONS
  The results support PD, and central hypoadrenalism in particular, as a contributing factor for impaired health-related QoL in patients after SAH.
authors.affiliation: Division of Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden. Electronic address: erik.kronvall@med.lu.se.
authors.forename: Erik
authors.initials: E
authors.lastname: Kronvall
authors.affiliation: Division of Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Sonesson
authors.affiliation: Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Stig
authors.initials: S
authors.lastname: Valdemarsson
authors.affiliation: Division of Neuroradiology, Department of Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Roger
authors.initials: R
authors.lastname: Siemund
authors.affiliation: Division of Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Säveland
authors.affiliation: Division of Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Ola G
authors.initials: OG
authors.lastname: Nilsson
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010900:Pituitary Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D017678:Sex Distribution; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology* / Q000523:psychology* / Q000601:surgery; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome
keywords: Aneurysmal subarachnoid hemorrhage; Hypopituitarism; Outcome; Pituitary dysfunction; Quality of life