Predictors of work status and quality of life 9–13 years after aneurysmal subarachnoid hemorrahage

• Published in: Acta neurochirurgica 2012-08, Vol.154 (8), p.1437-1446
• Main Authors: Vilkki, Juhani, Juvela, Seppo, Malmivaara, Kirsi, Siironen, Jari, Hernesniemi, Juha
• Format: Article
• Language: English
• Subjects: Adult; Age; Aged; Aneurysm; Aneurysm, Ruptured - complications; Aneurysm, Ruptured - physiopathology; Aneurysm, Ruptured - psychology; Clinical Article; Cognitive ability; Data processing; Female; Follow-Up Studies; Humans; Interventional Radiology; Inventories; Learning; Male; Medicine; Medicine & Public Health; Memory; Middle Aged; Minimally Invasive Surgery; Neurology; Neuropsychological Tests; Neuroradiology; Neurosurgery; Pattern recognition; Quality of Life; Sex; subarachnoid hemorrhage; Subarachnoid Hemorrhage - complications; Subarachnoid Hemorrhage - physiopathology; Subarachnoid Hemorrhage - psychology; Surgical Orthopedics; Surveys and Questionnaires; Time Factors; Work
• ISSN: 0001-6268; 0942-0940
• DOI: 10.1007/s00701-012-1417-y

Background Aneurysmal subarachnoid hemorrhage (SAH) causes long-term psychosocial impairments even in patients who regain functional independence. Little is known about predictors of these impairments. We studied how early clinical data and neuropsychological results predict work status and health-related quality of life (HRQoL) 9–13 years after SAH. Methods One hundred one patients performed a neuropsychological test battery and returned their self-rating and partner’s rating of a psychosocial impairment questionnaire approximately 1 year after SAH. These data were analyzed for association to the patients’ work status and self-rated HRQoL approximately 10 years later. Results Age inversely, lower levels of self-rated impairments, employment and higher levels of education at the first follow-up independently predicted employment at the long-term follow-up. Although most cognitive test results were significantly associated with employment status at the long-term follow-up, they were of limited additional value as predictors of work status. The best predictor combination for long-term high HRQoL was good performance in a face recognition test and lower levels of self-rated impairments at the first follow-up as well as male sex. Problems in usual activities at the long-term follow-up were predicted by poor results in the face recognition and in a word list-learning task. Conclusion Questionnaire ratings of patients’ psychosocial impairments 1 year after SAH give important information for the long-term prediction of their work status and HRQoL. In the long run, patients’ unemployment becomes strongly associated with higher age, while their performance of usual activities can be predicted with learning and memory results.