Survival, Dependency, and Health-Related Quality of Life in Patients With Ruptured Intracranial Aneurysm: 10-Year Follow-up of the United Kingdom Cohort of the International Subarachnoid Aneurysm Trial.
Neurosurgery
; 88(2): 252-260, 2021 01 13.
Article
en En
| MEDLINE
| ID: mdl-33073847
ABSTRACT
BACKGROUND:
Previous analyses of the International Subarachnoid Aneurysm Trial (ISAT) cohort have reported on clinical outcomes after treatment of a ruptured intracranial aneurysm with either neurosurgical clipping or endovascular coiling.OBJECTIVE:
To evaluate the long-term quality-adjusted life years (QALYs) gained of endovascular coiling compare to neurosurgical clipping in the UK cohort of ISAT.METHODS:
Between September 12, 1994 and May 1, 2002, patients with ruptured intracranial aneurysms who were assumed treatment equipoise were randomly allocated to either neurosurgical clipping or endovascular coiling. We followed-up 1644 patients in 22 UK neurosurgical centers for a minimum of 10 yr. Health-related quality of life (HRQoL) was collected through yearly questionnaires, measured by utilities calculated from the EQ-5D-3L. We compared HRQoL between the 2 treatment groups over a period of 10 yr. In all, 1-yr, 5-yr, and 10-yr QALYs were estimated by combining utility and survival information.RESULTS:
Higher average utility values were found in the endovascular group throughout the follow-up period, with mean differences between groups statistically significant in most years. The 10-yr QALYs were estimated to be 6.68 (95% CI 6.45-6.90) in the coiling group and 6.32 (95% CI 6.10-6.55) in the clipping group, respectively, a significant mean difference of 0.36 (95% CI 0.04-0.66). A third of this mean QALYs gain was estimated to derive solely from HRQoL differences.CONCLUSION:
HRQoL after treatment of a ruptured intracranial aneurysm was better after endovascular coiling compared to neurosurgical clipping, which contributed significantly to the QALYs gained over a 10-yr period.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Calidad de Vida
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Aneurisma Intracraneal
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Aneurisma Roto
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Procedimientos Neuroquirúrgicos
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Procedimientos Endovasculares
Tipo de estudio:
Clinical_trials
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Observational_studies
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Prognostic_studies
Límite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Neurosurgery
Año:
2021
Tipo del documento:
Article
País de afiliación:
Reino Unido