Targeting health-related quality of life issues not found with functional outcome measures a year after aneurysm subarachnoid hemorrhage in a Swedish national cohort.

PURPOSE: Outcome after aneurysmal subarachnoid hemorrhage (aSAH) is often devastating with life time issues also for independent survivors. We aimed to identify health related quality of life (HRQoL) issues in this favorable functional outcome group compared to a sex and age matched general population.

METHODS

We have analyzed data from 634 Swedish aSAH patients from a national prospective study ranging between 2014 and 2018. One year after ictus, functional outcome was analyzed using Glasgow Outcome Scale Extended (GOSE) and HRQoL assessed by Euro-quality of life-5 dimensions-3 levels (EQ-5D-3L). Favorable GOSE (5-8) were found in 471 patients. Age- and sex-matched populations were created by published data from a cross-sectional cohort of 32,597 people living in Stockholm County in 2006. Odds ratios (ORs) for rating a specific EQ-5D-3L level were calculated for each domain. Significance was set at α = 0.001.

RESULTS

Patients reported less mobility problems than the matched general population (9.6% vs 14.7%; OR 0.62 p = 0.002). However, with usual activities significantly more difficulties with moderate, (24.0% vs 10.9%; OR 2.58, p < .001) and any problems (27.0% vs 12.5%; OR 2.58, p < .001) were reported. More issues with extreme anxiety/depression were also reported ((5.3% vs 2.8%; OR 1.94; p = 0.002). Unfavorable GOSE patients were doing worse than the matched population in all levels and dimensions measured (Online Resource 1, 2, 3 and 4).

CONCLUSION

Although patients with favorable functional outcome report good or better mobility compared to their age and sex matched general population, they have significantly more issues with usual activities a year after aSAH more extreme issues with anxiety/depression were also reported To our knowledge, this is the first time EQ-5D-3L data is compared in a national group of aSAH patients with favorable functional outcome to a sex and age matched general population.