Artikel
Long-term quality of life of elderly patients after aneurysmal subarachnoid hemorrhage
Lebensqualität bei älteren Patienten nach Subarachnoidalblutung: Langzeitergebnisse
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Autoren
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Astrid Weyerbrock
- Neurochirurgische Universitätsklinik, Abteilung Allgemeine Neurochirurgie, Universitätsklinikum Freiburg, Freiburg
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B. Baumer
- Neurochirurgische Universitätsklinik, Abteilung Allgemeine Neurochirurgie, Universitätsklinikum Freiburg, Freiburg
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A. Berlis
- Sektion Neuroradiologie, Neurozentrum, Universitätsklinikum Freiburg, Freiburg
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V. van Velthoven
- Neurochirurgische Universitätsklinik, Abteilung Allgemeine Neurochirurgie, Universitätsklinikum Freiburg, Freiburg
| Veröffentlicht: | 23. April 2004 |
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Gliederung
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Objective
In patients older than 70 years, the decision to treat ruptured intracranial aneurysms remains difficult as clinical outcome appears to be significantly age-dependent.
Methods
Long-term quality of life (QoL) of 462 patients treated for aneurysmal subarachnoid hemorrhage was assessed by Modified Rankin Scale(MRS) and the SF-36 questionnaire and analyzed with regard to age ±70 years.
Results
Among 462 SAH patients, 54 patients were older than 70(8.5%). Long-term MRS scores were obtained in 68%, 66% of SF-36 questionnaires were returned. Mean follow-up time was 58±37 months. At follow-up time, the percentage of patients in a good MRS grade(1-3) was significantly lower in the older population(27.5% vs. 64%, p>0.005). 65% patients>70 years were dead at follow-up compared to 22% of the younger patients(p<0.0001). Cause of death could be obtained in 72%, it was related to the SAH or its consequences in 73% of the younger and 56% of the older patients. QoL as determined by the SF-36 was significantly worse in patients>70 years who achieved 33±45 compared to 79±39 points in the younger age group(p<0.0001). Long-term QoL significantly correlated with the admission H&H score in all SAH patients(p<0.0001). In the older group, all patients with H&HII-V had MRS scores of 4 or worse (handicapped or dead).
Conclusions
Quality of life assessment of patients with SAH showed a significantly worse long-term outcome in elderly patients. As clinical outcome was strongly correlated with admission H&H, only older patients in good clinical status should be treated after careful consideration of all relevant clinical parameters.
