Long-term functional outcomes after aneurysmatic subarachnoid hemorrhage: a review
Abstract Background Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating disease associated with high mortality. Despite improvements in survival, morbidity, associated societal burden and economic cost in survivors remains high. Comprehensive data on long-term cognitive outcomes in aSAH survi...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2025-04-01
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| Series: | Egyptian Journal of Neurosurgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41984-025-00413-w |
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| Summary: | Abstract Background Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating disease associated with high mortality. Despite improvements in survival, morbidity, associated societal burden and economic cost in survivors remains high. Comprehensive data on long-term cognitive outcomes in aSAH survivors are lacking. The aim is to summarize empirical data on the extent and cognitive sequelae of aSAH and their impact on quality of life of survivors. Methods A systematic review of MEDLINE (via PubMed) was performed using the terms “aneurysmal subarachnoid hemorrhage” and “long term outcome” to identify peer-reviewed publications in English reporting on cognitive and functional outcomes and quality of aSAH survivors at least 1 year after the onset of aSAH. Excluded were studies not written in English, with follow-up less than 1 year. Data were extracted on type of treatment, number of patients, mortality, and clinical outcome. Results The initial search yielded 1111 items, and 100 were included in the review: 76 reported a global functional outcome, 15 cognitive and/or emotional outcome, and nine work and social capacity outcomes. Modified Rankin score (mRS) was reported in 40 studies: 30 studies (75%) reported over 50% of patients having a good (mRS 0–2) score. Glasgow outcome score (GOS) was reported in 36 studies—24 studies reported a GOS 4 (moderate) or 5 (low disability). Among them, the majority (n = 20, 83.3%) had an above 50% proportion, and 14 (58.3%) above 70%. Cognitive deficits were reported in a range from 5.4 to 70.4% of aSAH survivors. Hindered vocational and social disability was reported in most patients. Conclusion Cognitive and emotional decline in aSAH survivors is substantial and its assessment should be considered routinely. Although global outcomes are favorable, there are coarse grained and fail to address the full extent of difficulties these patients face in activities of daily living, in social and vocational roles. |
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| ISSN: | 2520-8225 |