Artikel
Disease-specific health-related quality of life after fibrinolytic therapy in spontaneous intracerebral haemorrhage
Krankheitsspezifische und gesundheitsbezogene Lebensqualität nach fibrinolytischer Therapie bei spontaner intrazerebraler Hirnblutung
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Autoren
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Regina Schwiddessen
- Universitätsmedizin Göttingen, Neurochirurgische Klinik, Göttingen, Deutschland
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Vesna Malinova
- Universitätsmedizin Göttingen, Neurochirurgische Klinik, Göttingen, Deutschland
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Nicole von Steinbüchel-Rheinwall
- Universitätsmedizin Göttingen, Medizinische Psychologie und medizinische Soziologie, Göttingen, Deutschland
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Silvia Hernández-Durán
- Universitätsmedizin Göttingen, Neurochirurgische Klinik, Göttingen, Deutschland
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Dorothee Mielke
- Universitätsmedizin Göttingen, Neurochirurgische Klinik, Göttingen, Deutschland
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Veit Rohde
- Universitätsmedizin Göttingen, Neurochirurgische Klinik, Göttingen, Deutschland
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Christian von der Brelie
- Universitätsmedizin Göttingen, Neurochirurgische Klinik, Göttingen, Deutschland
| Veröffentlicht: | 25. Mai 2022 |
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Gliederung
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Objective: Spontaneous intracerebral haemorrhage (ICH) might have devastating consequences for all life dimensions. Outcome assessments frequently focus on physical impairment or mortality. This is the first study assessing disease-specific health-related quality of life (hrQoL) in order to better understand patients´ perspective. We want to enhance the insight to hrQoL beyond functional outcome.
Methods: We identified all patients with supratentorial ICH treated by fibrinolytic therapy (2010 to 2020) and conducted a retrospective analysis of demographic and clinical parameters. Life quality was prospectively analysed using a standardized telephone interview. Long-term functional outcome (measured by the modified Rankin Scale (mRS)) was evaluated as well as hrQoL (assessed by the QUALITY of life after Brain Injury Overall scale, the QOLIBRI-OS). Patients or their proxies were interviewed.
Results: Among 312 patients, 204 (65%) were discharged alive. 80 of these potential participants were still alive when this study was undertaken, 63 (31%; 35 male and 28 female patients, mean age at surgery: 67 years) participated in follow-up assessment (27 patients; 36 proxies). The mean follow-up period was 71 ± 40 months. The median ICH score was 3 (0= 1.6%, 1=14.3%, 2= 30.2% 3=44.4%, 4=9.5%; 5=0%). The mean QOLIBRI-OS value was 49.6 ± 27.7 (max. value 100), arguing for an impaired hrQoL (e.g. compared with data from ischemic stroke patients). Self-rated hrQoL (QOLIBRI-OS) was significantly higher than proxy-rated hrQoL (p<0,01). Despite high ICH scores, some patients achieved surprisingly high hrQoL (ICH score 4: QOLIBIR-OS M:50; SD:30.4), we found no association between high ICH Score and lower hrQoL (p=0.25). QOLIBRI-OS values for the subdomains “emotion”, “cognition” and “social/ personal life” were significantly higher than “physical condition” and “function in daily life” (p<0,01). Moreover, the subdomains “emotion” and “social/ personal life” were significantly higher rated than the subdomain “current situation/future prospects” (p<0,01).
Conclusion: Disease-specific hrQoL after ICH is significantly impaired and varies widely. Assessment of hrQoL is a need to better understand the benefits of fibrinolytic treatment. It complements previous studies on functional outcome and clinical grading scales by including the patient’s perspective.
