Long-term health-related quality of life after aneurysmal subarachnoid hemorrhage: relationship with psychological symptoms and personality characteristics

Abstract

Background and purpose: Many patients who survive an aneurysmal subarachnoid hemorrhage experience decreased health-related quality of life (HRQoL). Physical factors have been identified as determinants of HRQoL. We describe long-term HRQoL and assessed whether psychological symptoms and personality characteristics determine HRQoL after subarachnoid hemorrhage.

Methods: In a cross-sectional study in 141 patients living independently in the community 2 to 4 years after subarachnoid hemorrhage, we assessed whether HRQoL, evaluated by the Stroke Specific Quality of Life scale, was related to psychological symptoms (mood disorders, fatigue, and cognitive complaints), personality characteristics (neuroticism and passive coping style), demographic characteristics, and subarachnoid hemorrhage disease characteristics.

Results: Best Stroke Specific Quality of Life scale scores were found in the physical domain and worst in the emotional and social domains. Thirty-two percent reported anxiety, 23% depression, and 67% fatigue. Mood (beta between -0.42 and -0.18), fatigue (beta between -0.40 and -0.24), and cognitive complaints (beta between -0.46 and -0.16) were strongly associated with Stroke Specific Quality of Life scale scores in multivariate regression analyses.

Conclusions: Depression, anxiety, and fatigue were present in a substantial proportion of patients and were strongly related to decreased HRQoL. These symptoms identified are helpful to tailor rehabilitation to the needs of patients in the chronic phase after subarachnoid hemorrhage.