Abstract
Background
Aneurysmal subarachnoid hemorrhage (SAH) causes long-term psychosocial impairments even in patients who regain functional independence. Little is known about predictors of these impairments. We studied how early clinical data and neuropsychological results predict work status and health-related quality of life (HRQoL) 9–13 years after SAH.
Methods
One hundred one patients performed a neuropsychological test battery and returned their self-rating and partner’s rating of a psychosocial impairment questionnaire approximately 1 year after SAH. These data were analyzed for association to the patients’ work status and self-rated HRQoL approximately 10 years later.
Results
Age inversely, lower levels of self-rated impairments, employment and higher levels of education at the first follow-up independently predicted employment at the long-term follow-up. Although most cognitive test results were significantly associated with employment status at the long-term follow-up, they were of limited additional value as predictors of work status. The best predictor combination for long-term high HRQoL was good performance in a face recognition test and lower levels of self-rated impairments at the first follow-up as well as male sex. Problems in usual activities at the long-term follow-up were predicted by poor results in the face recognition and in a word list-learning task.
Conclusion
Questionnaire ratings of patients’ psychosocial impairments 1 year after SAH give important information for the long-term prediction of their work status and HRQoL. In the long run, patients’ unemployment becomes strongly associated with higher age, while their performance of usual activities can be predicted with learning and memory results.
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Abbreviations
- CT:
-
computed tomography
- EuroQol:
-
European quality of life
- HRQoL:
-
health-related quality of life
- SAH:
-
subarachnoid hemorrhage
- WAIS–R:
-
Wechsler Adult Intelligence Scale–Revised
References
Al-Khindi T, Macdonald L, Schweizer TA (2010) Cognitive and functional outcome after aneurysmal subarachnoid hemorrhage. Stroke 41:519–536
Barker-Collo S, Feigin V (2006) The impact of neuropsychological deficits on functional stroke outcomes. Neuropsychol Rev 16:53–64
Benton AL (1963) The revised visual retention test: clinical and experimental applications. The Psychological Corporation, New York
Brooks R (1996) EuroQol Group. EuroQol: the current state of play. Health Policy 37:53–72
Cattell RB, Cattell AK (1960) Handbook for the individual or group culture fair intelligence test (A Measure of “g”) Scale 2, Forms A and B. Institute for Personality and Ability Testing, Champaign
Duncan J, Hazel E, Williams B (1996) Intelligence and the frontal lobe: the organization of goal-directed behaviour. Cogn Psychol 30:257–303
Greebe P, Rinkel GJE, Hop JW, Visser-Meily A, Algra A (2010) Functional outcome and quality of life 5 and 12.5 years after aneurysmal subarachnoid haemorrhage. J Neurol 257:2059–2064
Hop JW, Rinkel GJE, Algra A, van Gijn J (1998) Quality of life in patients and partners after subarachnoid hemorrhage. Stroke 29:798–804
Juvela S, Siironen J, Varis J, Poussa K, Porras M (2005) Risk factors for ischemic lesions following aneurismal subarachnoid hemorrhage. J Neurosurg 102:194–201
Niskanen MM, Hernesniemi JA, Vapalahti MP, Kari A (1993) One-year outcome in early aneurysm surgery: prediction of outcome. Acta Neurochir 123:25–32
Samra SK, Giordani B, Caveney AF, Clarke WR, Scott PA, Anderson S, Thompson BG, Todd MM (2007) Recovery of cognitive function after surgery for aneurysmal subarachnoid hemorrhage. Stroke 38:1864–1872
Siironen J, Juvela S, Varis J, Porras M, Poussa K (2003) No effect of enoxaparin on outcome of aneurysmal subarachnoid hemorrhage: a randomized double-blind placebo-controlled clinical trial. J Neurosurg 99:953–959
UK-TIA Study Group (1988) United Kingdom transient ischemic attack (UK-TIA) aspirin trial. Interim results—UK-TIA study group. Brit Med J (Clin Res Ed) 296:316–320
Vilkki JS, Juvela S, Siironen J, Ilvonen T, Varis J, Porras M (2004) Relationship of local infarctions to cognitive and psychosocial impairments after aneurysmal subarachnoid hemorrhage. Neurosurgery 35:790–803
Visser-Meily JM, Rhebergen ML, Rinkel GJE, van Zandvoort MJ, Post MWM (2009) Long-term health-related quality of life after aneurysmal subarachnoid hemorrhage: relationship with psychological symptoms and personality characteristics. Stroke 40:1526–1529
Wechsler D (1992) Wechsler Adult Intelligence Scale–Revised. (Finnish WAIS-R handbook). Psykologien Kustannus Oy, Helsinki
Wermer MJH, Kool H, Albrecht KW, Rinkel GJE (2007) Subarachnoid hemorrhage treated with clipping: Long-term effects on employment, relationships, personality, and mood. Neurosurgery 60:91–98
Acknowledgements
We thank Pekka Lahti-Nuuttila, M.A., and Jaakko Lappalainen, M.D., Ph.D., for valuable advice and comments.
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Vilkki, J., Juvela, S., Malmivaara, K. et al. Predictors of work status and quality of life 9–13 years after aneurysmal subarachnoid hemorrahage. Acta Neurochir 154, 1437–1446 (2012). https://doi.org/10.1007/s00701-012-1417-y
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DOI: https://doi.org/10.1007/s00701-012-1417-y