Spontaneous Aneurysmal Subarachnoid Hemorrhage and Related Cortisol and Immunologic Alterations: Impact on Patients' Health-related Quality of Life
| Autor: | Sami Ridwan, Jan Boström, Dietrich Klingmüller, Azize Boström, Bernd Zur, Susanne Greschus, Jonas Esche, Julio Barrera |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Subarachnoid hemorrhage Hydrocortisone Population 03 medical and health sciences 0302 clinical medicine Quality of life Modified Rankin Scale Surveys and Questionnaires Internal medicine medicine Humans Survivors education Depression (differential diagnoses) Aged Health related quality of life education.field_of_study Interleukin-6 business.industry Beck Depression Inventory Middle Aged Subarachnoid Hemorrhage medicine.disease humanities Fatigue impact scale 030104 developmental biology Quality of Life Female Surgery Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neurological Surgery Part A: Central European Neurosurgery. 80:371-380 |
| ISSN: | 2193-6323 2193-6315 |
| DOI: | 10.1055/s-0039-1677827 |
| Popis: | Objective To highlight the impact of aneurysmal subarachnoid hemorrhage (SAH) on surviving patients' health-related quality of life (HRQoL) with respect to cortisol and interleukin (IL)-6 alterations and also to identify possible clinical predictors for a better HRQoL. Methods Fifty surviving patients treated in our hospital for aneurysmal SAH in a 2-year period with sufficient HRQoL data were enrolled. A good clinical outcome was represented by the modified Rankin Scale (mRS) 0 to 2. The patient's HRQoL was assessed using the Short Form health survey questionnaire, the Beck Depression Inventory, and the Daily Fatigue Impact Scale at 6 and 12 months. The results were analyzed regarding possible correlation to 24-hour urinary free cortisol, serum, and cerebrospinal fluid IL-6 levels. Results A reduction of HRQoL in up to 35% of survivors was observed at 6 months and in a high proportion of patients (47.2%) with an assumable good outcome (mRS 0–2). Reduced HRQoL in survivors was found in terms of SF-36 (34.9%), depression (26.8%), and fatigue (14%) at 6 months and 18.4%, 39.4%, and 18.9% at 12 months, respectively. Improvement was recorded at 12 months, mainly in SF-36. Early elevated 24-hour urinary free cortisol and IL-6 levels showed a significant positive impact on HRQoL. Conclusions Early cortisol and IL-6 levels may predict patients' HRQoL after SAH. Twelve months after SAH, a considerable percentage of patients with a presumably good outcome (mRS 0–2) had a lower HRQoL compared with the general population. Implementing corresponding tests at discharge and 12-month follow-up is recommended. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|