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. 2014 Apr 3;4(4):e003932.
doi: 10.1136/bmjopen-2013-003932.

Self-perceived health status following aneurysmal subarachnoid haemorrhage: a cohort study

Audrey C Quinn  1 , Deepti Bhargava, Yahia Z Al-Tamimi, Matthew J Clark, Stuart A Ross, Alan Tennant
Affiliations

Self-perceived health status following aneurysmal subarachnoid haemorrhage: a cohort study

Audrey C Quinn et al. BMJ Open. .

Abstract

Objective: The objective of the study was to assess the long-term self-reported health status and quality of life (QoL) of patients following an aneurysmal subarachnoid haemorrhage (ASAH) using a self-completed questionnaire booklet.

Design: A two-cohort study.

Setting: A regional tertiary neurosurgical centre.

Participants: 2 cohorts of patients with ASAH treated between 1998 and 2008 and followed up at approximately 1 year.

Interventions: Routine care.

Primary and secondary outcomes: A range of standardised scales included: AKC Short Sentences Test, the Barthel Index, the Self-Report Dysexecutive Questionnaire, the Everyday Memory Questionnaire, Stroke Symptom Checklist, Wimbledon Self-Report Scale, Modified Rankin Score (MRS) and a new Stroke-QoL. The data from summated scales were fit to the Rasch measurement model to validate the summed score.

Results: 214 patients (48%) returned the questionnaires; the majority (76%) had a World Federation of Neurosurgeons grade of 1 or 2. The most frequent aneurysm type was that of the anterior communicating artery (28%) with approximately 90% of aneurysms of the anterior circulation. Of those previously in full or part-time employment, 48.9% were unemployed at follow-up. All summated scales satisfied the Rasch measurement model requirements, such that their summed scores were a sufficient statistic. Given this, one-third of patients were noted to have a significant mood disorder and 25% had significant dysexecutive function. Patients with an MRS of 3, 4 or 5 had significantly worse scores on most outcome measures, but a significant minority of those with a score of zero had failed to return to work and displayed significant mood disorder.

Conclusions: A range of self-reported cognitive and physical deficits have been highlighted in a cohort of patients with ASAH. While the MRS has been shown to provide a reasonable indication of outcome, in routine clinical follow-up it requires supplementation by instruments assessing dysexecutive function, memory and mood.

Keywords: Stroke Medicine.

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Figures

Figure 1
Figure 1
Distribution of Dysexecutive Function Questionnaire Score.
See this image and copyright information in PMC

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