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Determinants of health-related quality of life after aneurysmal subarachnoid hemorrhage: a systematic review

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Abstract

Background and purpose

Many persons with subarachnoid hemorrhage (SAH) from a ruptured intracranial aneurysm recover to functional independence but nevertheless experience reduced quality of life (QoL). The aim of this study was to summarize the evidence on determinants of reduced QoL in this diagnostic group.

Methods

Databases PubMed, PsychINFO, and CINAHL were used to identify empirical studies reporting on quantitative relationships between possible determinants and QoL in persons with aneurysmal SAH and published in English. Determinants were classified using the International Classification of Functioning, Disability and Health (ICF).

Results

Twenty studies met the inclusion criteria for this review, in which 13 different HRQoL questionnaires were used. Determinants related to Body Structure & Function (clinical condition at admission, fatigue, and disturbed mood), Activity limitations (physical disability and cognitive complaints), and Personal factors (female gender, higher age, neuroticism, and passive coping) are consistently related to worse HRQoL after aneurysmal SAH. Treatment characteristics were not consistently related to HRQoL.

Conclusion

This study identified a broad range of determinants of HRQoL after aneurysmal SAH. The findings provide clues to tailor multidisciplinary rehabilitation programs. Further research is needed on participation, psychological characteristics, and environmental factors as determinants of HRQoL after SAH.

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Abbreviations

ACTH:

Adreno-cortico-trophic hormone

AcomA:

Anterior communicating artery

ALQI:

Aachen Life Quality Inventory

ASA:

Acetylsalicylic acid

BDI:

Beck Depression Inventory

CFQ:

Cognitive Failure Questionnaire

CSF:

Cerebrospinal fluid

EPQ-N:

Eysenck Personality Questionnaire

EQ-5D:

Euro-QoL 5 dimensions

EQ VAS:

Euro-QoL Visual Analog Scale

FLP:

Functional Limitations Profile

FSS:

Fatigue Severity Scale

GCS:

Glasgow Coma Scale

GH:

Growth hormone

GHQ:

General Health Questionnaire-30

GOS:

Glasgow Outcome Scale

HADS:

Hospital Anxiety and Depression Scale

H&H:

Hunt and Hess Scale

HRQoL:

Health-related Quality of Life

ICF:

International classification of functioning, disability, and health

LQLP:

Lancaster Quality of Life Profile

MCA:

Middle cerebral artery

MMSE:

Mini-Mental State Examination

mRS:

Modified Rankin Scale

NHP:

Nottingham Health Profile QoL

NPRI:

Nicardipine prolonged-release implants

NR:

Not reported

QoL:

Quality of Life

QoL-AGHDA:

Quality of Life assessment of growth hormone deficiency in adults

SAH:

Subarachnoid hemorrhage

SF-36:

Short-form health survey

SIP:

Sickness Impact Profile

SS-QoL:

Stroke-Specific Quality of Life

UCL-p:

Utrecht Coping List

VAS:

Visual Analog Scale

WFNS:

World Federation of neurological surgeons scale

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Authors and Affiliations

  1. Rudolf Magnus Institute of Neuroscience and Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht and Rehabilitation Centre De Hoogstraat, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands

    P. E. C. A. Passier, J. M. A. Visser-Meily, E. Lindeman & M. W. M. Post

  2. Merem Rehabilitation Centre De Trappenberg, Flevohospital, Almere, The Netherlands

    P. E. C. A. Passier

  3. Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands

    G. J. E. Rinkel

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  1. P. E. C. A. Passier
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Correspondence to J. M. A. Visser-Meily.

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Passier, P.E.C.A., Visser-Meily, J.M.A., Rinkel, G.J.E. et al. Determinants of health-related quality of life after aneurysmal subarachnoid hemorrhage: a systematic review. Qual Life Res 22, 1027–1043 (2013). https://doi.org/10.1007/s11136-012-0236-1

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