Prospective study: Long-term outcome at 12-15 years after aneurysmal subarachnoid hemorrhage

Area of Science:

• Neurology
• Neurosurgery
• Public Health

Background:

• Aneurysmal subarachnoid hemorrhage (aSAH) is associated with poor patient outcomes.
• Long-term recovery and outcomes beyond one year post-aSAH are not well-documented.
• This study investigates late functional recovery and long-term survival in aSAH patients.

Purpose of the Study:

• To assess functional improvement more than one year after aSAH.
• To compare long-term mortality in aSAH patients versus matched controls.
• To identify predictors of favorable long-term outcomes (Glasgow Outcome Scale 4-5).

Main Methods:

• Prospective study of patients admitted between 2000-2003.
• Initial assessment at one year post-aSAH using the Glasgow Outcome Scale (GOS).
• Re-evaluation 12-15 years post-aSAH via structured telephone interviews and statistical analysis.

Main Results:

• 158 patients included; 103 survivors at 12-15 year follow-up.
• 23.6% of patients showed GOS improvement after the first year.
• aSAH patients had 3.5 times higher mortality than controls; favorable 1-year GOS predicted similar survival to controls.
• Low age and high 1-year GOS predicted favorable long-term outcomes (AUCROC, 0.79).

Conclusions:

• Functional improvement can occur more than one year after aSAH.
• Patients with a favorable GOS at one year have comparable long-term life expectancy to the general population.
• Low age at ictus and high GOS at one year are key indicators for favorable long-term prognosis.