Long-term domain-specific improvement following poor grade aneurysmal subarachnoid hemorrhage

J. Mocco, Evan R. Ransom, Ricardo J. Komotar, Paulina B. Sergot, Noeleen Ostapkovich, J. Michael Schmidt, Kurt T. Kreiter, Stephan A. Mayer, E. Sander Connolly

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Background: While efforts have been made to document short-term outcomes following poor grade aneurysmal subarachnoid hemorrhage (aSAH), no data exist concerning the degree of delayed improvement in neurological function. Here we assess cognitive function, level of independence, and quality of life (QoL) over 12 months following poor grade aSAH. Methods: Data on definitively treated poor grade patients (Hunt and Hess grade IV or V) surviving 12 months post-aSAH were obtained through a prospectively maintained SAH database. Demographic information, medical history, and clinical course were analyzed. Health outcomes assessments completed by surviving patients at discharge (DC), three months (3 M) and 12 months (12 M) follow-up, including the Telephone Interview for Cognitive Status (TICS), Barthel Index (BI), and Sickness Impact Profile (SIP), were used to evaluate cognitive function, level of independence, and QoL. Findings: Fifty-six poor grade patients underwent aneurysm-securing intervention and survived at least 12 months post-aSAH. Thirty-five (63%) surviving patients underwent health outcomes assessments at DC, 3 M and 12 M post-aSAH. A majority of patients had improved scores on the TICS (DC to 3 M: 91%; 3 M to 12 M: 82%), BI (DC to 3 M: 96%; 3 M to 12 M: 92%), and SIP (3 M to 12 M: 80%) following aSAH. Using paired-sample analyses, significant improvement on each test was observed. Conclusion: A substantial portion of patients experience cognitive recovery, increased independence, and improved QoL following poor grade aSAH. Delayed follow-up assessments are necessary when evaluating functional recovery in this population. These findings have the potential to impact poor grade aSAH management and prognosis.

Original languageEnglish (US)
Pages (from-to)1278-1284
Number of pages7
JournalJournal of Neurology
Volume253
Issue number10
DOIs
StatePublished - Oct 1 2006
Externally publishedYes

Keywords

  • Aneurysm
  • Critical care
  • Outcome
  • Poor grade
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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    Mocco, J., Ransom, E. R., Komotar, R. J., Sergot, P. B., Ostapkovich, N., Schmidt, J. M., Kreiter, K. T., Mayer, S. A., & Connolly, E. S. (2006). Long-term domain-specific improvement following poor grade aneurysmal subarachnoid hemorrhage. Journal of Neurology, 253(10), 1278-1284. https://doi.org/10.1007/s00415-006-0179-y