Health-related quality of life 10 years after intracranial aneurysm rupture: a retrospective cohort study using EQ-5D.

ABSTRACT

BACKGROUND: Experiencing an aneurysmal subarachnoid hemorrhage (SAH) could affect health-related quality of life (HRQoL) several years after the onset. Long-term studies are scarce, and there is a lack of knowledge of whether HRQoL is affected > 5 years after the onset and, if so, in what dimensions. In the general population, HRQoL decreases with age and with the occurrence of a disease and differs between sexes. Factors that may influence HRQoL after aneurysmal SAH include neurological outcome, perceived recovery, aneurysm treatment, and family support. OBJECTIVE: To measure HRQoL and to explore factors affecting HRQoL 10 years after aneurysmal SAH. METHODS: A consecutive sample of all patients admitted for intracranial aneurysm rupture at a neurosurgical clinic in Stockholm (n = 217, 79.5% of eligible) were followed up from 2007 to 2008, approximately 10 years after aneurysm rupture. HRQoL was measured with EQ-5D, and the results were compared with a general population sample from the Stockholm Public Health Survey 2006 matched by age and sex. RESULTS: Compared with the general population, the aneurysm sample reported significantly more problems in 4 of 5 EQ-5D dimensions-mobility, self-care, usual activities, and anxiety/depression-and had significantly lower EQ-5Dindex and EQ visual analog scale values. Within the aneurysm sample, HRQoL was most affected in respondents with worse Glasgow outcome scale values at hospital discharge, respondents with comorbidities, and respondents with low perceived recovery. CONCLUSION: Aneurysmal SAH affects HRQoL to a large extent, even 10 years after the onset, indicating a need for long-term follow-up and support after the onset.