医学
社会心理的
生活质量(医疗保健)
蛛网膜下腔出血
物理疗法
人口
队列
焦虑
萧条(经济学)
康复
内科学
精神科
环境卫生
宏观经济学
护理部
经济
作者
Zahrah Taufique,Teresa May,Emma Meyers,Cristina Falo,Stephan A. Mayer,Sachin Agarwal,Soo‐Jin Park,E. Sander Connolly,Jan Claassen,J. Michael Schmidt
出处
期刊:Neurosurgery
[Oxford University Press]
日期:2016-02-01
卷期号:78 (2): 256-264
被引量:104
标识
DOI:10.1227/neu.0000000000001042
摘要
Risk factors for poor quality of life (QOL) after subarachnoid hemorrhage (SAH) remain poorly described.To identify the frequency and predictors of poor QOL 1 year after SAH.We studied 1-year QOL in a prospectively collected cohort of 1181 consecutively admitted SAH survivors between July 1996 and May 2013. Patient clinical, radiographic, surgical, and acute clinical course information was recorded. Reduced QOL (overall, physical, and psychosocial) at 1 year was assessed with the Sickness Impact Profile and defined as 2 SD below population-based normative Sickness Impact Profile values. Logistic regression leveraging multiple imputation to handle missing data was used to evaluate reduced QOL.Poor overall QOL was observed in 35% of patients. Multivariable analysis revealed that nonwhite ethnicity, high school education or less, history of depression, poor clinical grade (Hunt-Hess Grade ≥3), and delayed infarction were predictors of poor overall and psychosocial QOL. Poor physical QOL was additionally associated with older age, hydrocephalus, pneumonia, and sepsis. At 1 year, patients with poor QOL had increased difficulty concentrating, cognitive dysfunction, depression, and reduced activities of daily living. More than 91% of patients with poor QOL failed to fully return to work. These patients frequently received physical rehabilitation, but few received cognitive rehabilitation or emotional-behavioral support.Reduced QOL affects as many as one-third of SAH survivors 1 year after SAH. Delayed infarction is the most important in-hospital modifiable factor that affects QOL. Increased attention to cognitive and emotional difficulties after hospital discharge may help patients achieve greater QOL.
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