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Prospective study: Long‐term outcome at 12‐15 years after aneurysmal subarachnoid hemorrhage
Author(s) -
Rackauskaite D.,
Svanborg E.,
Andersson E.,
Löwhagen K.,
Csajbok L.,
Nellgård B.
Publication year - 2018
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12980
Subject(s) - medicine , subarachnoid hemorrhage , glasgow outcome scale , prospective cohort study , modified rankin scale , cohort , cohort study , pediatrics , surgery , glasgow coma scale , ischemic stroke , ischemia
Background Patients with aneurysmal subarachnoid hemorrhage (aSAH) have poor outcome. Studies on outcome beyond 1 year post‐aSAH are few, and late recovery is poorly investigated, initiating this prospective outcome study on patients 12‐15 years after an aSAH. We hypothesized to find; functional improvement > 1 year post‐ictus; increased long‐term mortality in aSAH patients vs matched controls, and finally to present; predictors of long‐term favorable outcome (GOS 4‐5). Methods We prospectively investigated patients, admitted 2000‐2003 to the Sahlgrenska University Hospital, 1 year post‐ictus using Glasgow Outcome Scale (GOS). The patients were revalidated 12‐15 years post‐aSAH by structured‐telephone interviews (GOS), followed by statistical analysis. Results A total of 158 patients were included, (women n = 114, men n = 44), with a mean age of 55 years at aSAH. Patients treated with surgical clipping had lower mortality. At the follow‐up 12‐15 years post‐aSAH, all 103 survivors (65.2%) were categorized as having; good recovery (39.9%), moderate disability (15.2%), or severe disability (10.1%). Within the patient cohort, 23.6% improved GOS over time. Fifty‐five patients died, median at 4 years post‐ictus. aSAH patients had 3.5 times increased mortality 12‐15 years post‐ictus vs matched controls ( P < .0001). Patients with favorable outcome at 1 year (67.3%, n = 101) had similar survival probability as control patients. Prognostic indicators of long‐term favorable outcome were low age and high GOS at 1‐year follow‐up, (AUCROC, 0.79). Conclusions Individual functional improvement was found >1 year post‐ictus. Patients with favorable outcome at 1 year had similar long‐term life expectancy as the general population. Indicators of long‐term favorable prognosis were low age at ictus and high GOS at 1‐year follow‐up.