gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Quality of life after poor-grade aneurysmal subarachnoid haemorrhage – prospective data from the hWFNS trial

Lebensqualität nach hochgradiger aneurysmatischer Subarachnoidalblutung – prospektive Daten der hWFNS Studie

Meeting Abstract

  • presenting/speaker Johannes Goldberg - Inselspital, Universitätsspital Bern, Universitätsklinik für Neurochirurgie, Bern, Schweiz
  • Werner J. Z´Graggen - Inselspital, Universitätsspital Bern, Universitätsklinik für Neurochirurgie, Bern, Schweiz
  • Mattia Branca - CTU Bern, University of Bern, Bern, Schweiz
  • Serge Marbacher - Kantonsspital Aarau, Klinik für Neurochirurgie, Aarau, Schweiz
  • Donato D’Alonzo - Kantonsspital Aarau, Klinik für Neurochirurgie, Aarau, Schweiz
  • Javier Fandino - Kantonsspital Aarau, Klinik für Neurochirurgie, Aarau, Schweiz
  • Martin N. Stienen - Universitätsspital Zürich, Klinik für Neurochirurgie, Zürich, Schweiz
  • Marian C. Neidert - Universitätsspital Zürich, Klinik für Neurochirurgie, Zürich, Schweiz
  • Jan-Karl Burkhardt - Universitätsspital Zürich, Klinik für Neurochirurgie, Zürich, Schweiz; Hospital of the University of Pennsylvania, Department of Neurosurgery, Philadelphia, PA, Vereinigte Staaten
  • Luca Regli - Universitätsspital Zürich, Klinik für Neurochirurgie, Zürich, Schweiz
  • Martin Hlavica - Kantonspital St. Gallen, Klinik für Neurochirurgie, St. Gallen, Schweiz
  • Martin Seule - Kantonspital St. Gallen, Klinik für Neurochirurgie, St. Gallen, Schweiz
  • Michel Roethlisberger - University Hospital Basel, Department of Neurosurgery, Basel, Schweiz
  • Raphael Guzman - University Hospital Basel, Department of Neurosurgery, Basel, Schweiz
  • Daniel Walter Zumofen - Maimonides Medical Center, Department of Surgery, Neurology, and Radiology, New York, NY, Vereinigte Staaten
  • Rodolfo Maduri - Avaton Surgical Group, Swiss Medical Network, Clinique de Genolier, Genolier, Schweiz
  • Roy Thomas Daniel - University Hospital Lausanne, Department of Neurosurgery, Lausanne, Schweiz
  • Amir El Rahal - Hopitaux Universitaires de Genève, Klinik und Poliklinik für Neurochirurgie, Genf, Schweiz
  • Marco V. Corniola - Hopitaux Universitaires de Genève, Klinik und Poliklinik für Neurochirurgie, Genf, Schweiz
  • Philippe Bijlenga - Hopitaux Universitaires de Genève, Klinik und Poliklinik für Neurochirurgie, Genf, Schweiz
  • Karl Schaller - Hopitaux Universitaires de Genève, Klinik und Poliklinik für Neurochirurgie, Genf, Schweiz
  • Roland Rölz - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Christian Scheiwe - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Mukesch Shah - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Dieter Henrik Heiland - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Oliver Schnell - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Jürgen Beck - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Andreas Raabe - Inselspital, Universitätsspital Bern, Universitätsklinik für Neurochirurgie, Bern, Schweiz
  • Christian Fung - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV106

doi: 10.3205/22dgnc108, urn:nbn:de:0183-22dgnc1088

Published: May 25, 2022

© 2022 Goldberg et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Poor-grade aneurysmal subarachnoid hemorrhage (aSAH) is associated with high mortality and poor outcome. Data on quality of life (QoL) among survivors is scarce. Here we present QoL- and outcome-data from the prospective multicentric hWFNS-trial (NCT02304328).

Methods: This study enrolled 250 patients suffering from poor-grade aSAH (WFNS grades IV and V) in 8 centers in Switzerland and Germany. Six months after ictus a structured telephone interview was conducted by an independent trained investigator or study nurse blinded to the clinical course to collect QoL- and outcome data. Outcome was measured with the modified Rankin scale. QoL was measured using the EQ-5D-3L questionnaire, which assesses health profiles in five dimensions (mobility, self-care, usual activities, pain and discomfort, anxiety and depression), each of which has three response levels (no problems, some problems, extreme problems). Furthermore, a health state index score was calculated from all individual EQ-5D-3L health profiles using a germany-specific value set of the general population as a reference. Values range from 0 to 1, where 0 is a health state equivalent to death and 1 is equivalent to perfect health.

Results: Of 237 patients that were included in the analysis, 118 (49.8%) were alive after 6 months (mRS 0-5) and 119 (50.2%) were dead (mRS 6). Of those alive, 82 (70%) were at home, 19 (16.3%) received permanent care in a nursing home and 16 (13.7%) were in a rehabilitation clinic. The proportion of patients reporting no problem versus any problem (some problems and extreme problems) for the respective five domians of the EQ-5D-3L were: Mobility: 63 (53.4%) vs 55 (46.6%); selfcare: 69 (58.5%) vs 49 (41.5%); usual activities: 50 (42.4%) vs 68 (57.6%); pain and discomfort: 67 (56.8%) vs. 51 (43.2%); anxiety and depression: 68 (59.7%) vs 46 (40.3%). 22 (19.3%) patients reported no problems in each domain of the EQ-5D. The overall health state index score was 0.75 (±0.29).

Conclusion: The proportion of survivors of poor-grade aSAH with good quality of life six months after ictus is reasonably large. Up to 19% of patients report no restrictions of any health domain of the EQ-5D-3L and 70% are at home. Only a small number of patients report poor quality of life and require permanent care.