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Prospective study: Long-term outcome at 12-15 years after aneurysmal subarachnoid hemorrhage
Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Mölndal, Sweden; Institution of clinical sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Mölndal, Sweden.
Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Mölndal, Sweden; Institution of clinical sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Mölndal, Sweden; Institution of clinical sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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2018 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 138, no 5, p. 400-407Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Patients with aneurysmal subarachnoid hemorrhage (aSAH) have poor outcome. Studies on outcome beyond 1 year post-aSAH are few, and late recovery is poorly investigated, initiating this prospective outcome study on patients 12-15 years after an aSAH. We hypothesized to find; functional improvement > 1 year post-ictus; increased long-term mortality in aSAH patients vs matched controls, and finally to present; predictors of long-term favorable outcome (GOS 4-5).

METHODS: We prospectively investigated patients, admitted 2000-2003 to the Sahlgrenska University Hospital, 1 year post-ictus using Glasgow Outcome Scale (GOS). The patients were revalidated 12-15 years post-aSAH by structured-telephone interviews (GOS), followed by statistical analysis.

RESULTS: A total of 158 patients were included, (women n = 114, men n = 44), with a mean age of 55 years at aSAH. Patients treated with surgical clipping had lower mortality. At the follow-up 12-15 years post-aSAH, all 103 survivors (65.2%) were categorized as having; good recovery (39.9%), moderate disability (15.2%), or severe disability (10.1%). Within the patient cohort, 23.6% improved GOS over time. Fifty-five patients died, median at 4 years post-ictus. aSAH patients had 3.5 times increased mortality 12-15 years post-ictus vs matched controls (P < .0001). Patients with favorable outcome at 1 year (67.3%, n = 101) had similar survival probability as control patients. Prognostic indicators of long-term favorable outcome were low age and high GOS at 1-year follow-up, (AUCROC, 0.79).

CONCLUSIONS: Individual functional improvement was found >1 year post-ictus. Patients with favorable outcome at 1 year had similar long-term life expectancy as the general population. Indicators of long-term favorable prognosis were low age at ictus and high GOS at 1-year follow-up.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2018. Vol. 138, no 5, p. 400-407
Keywords [en]
cerebrovascular diseases, neurointensive care, rehabilitation, strokes
National Category
Neurology
Identifiers
URN: urn:nbn:se:liu:diva-154600DOI: 10.1111/ane.12980ISI: 000446549700003PubMedID: 29963687Scopus ID: 2-s2.0-85050504073OAI: oai:DiVA.org:liu-154600DiVA, id: diva2:1290609
Available from: 2019-02-21 Created: 2019-02-21 Last updated: 2019-03-01Bibliographically approved

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