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

Autor: Xinyang Hua, Alastair Gray, Alison Clarke, Andrew J. Molyneux, Philip Clarke, Mary Sneade, Jane Wolstenholme, Richard S. C. Kerr, Oliver Rivero-Arias
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
International Subarachnoid Aneurysm Trial
medicine.medical_treatment
Neuros/4
Neuros/2
Aneurysm
Ruptured
Neurosurgical Procedures
0302 clinical medicine
Surveys and Questionnaires
Case fatality rate
030212 general & internal medicine
Aged
80 and over
Endovascular coiling
Endovascular Procedures
Middle Aged
Treatment Outcome
Cohort
cardiovascular system
Female
Adult
Quality of life
medicine.medical_specialty
Subarachnoid hemorrhage
Adolescent
Randomized controlled trail
AcademicSubjects/MED00930
03 medical and health sciences
Young Adult
Aneurysm
medicine
Neurosurgery 20/20: Concise
Clear Content
Humans
cardiovascular diseases
Research—Human—Clinical Trials
Aged
ComputingMethodologies_COMPUTERGRAPHICS
business.industry
Intracranial Aneurysm
Clipping (medicine)
Subarachnoid Hemorrhage
medicine.disease
United Kingdom
Quality-adjusted life year
Surgery
Neurology (clinical)
business
030217 neurology & neurosurgery
Follow-Up Studies
Zdroj: Neurosurgery
ISSN: 1524-4040
0148-396X
Popis: 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.
Graphical Abstract Graphical Abstract
Databáze: OpenAIRE
Externí odkaz: