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Return to work after aneurysmal subarachnoid hemorrhage.

Angelika Sorteberg1,2, Aslan Lashkarivand1,2, Elin Western3

  • 1Department of Neurosurgery, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.

Frontiers in Neurology
|May 15, 2024
PubMed
Summary

Survivors of aneurysmal subarachnoid hemorrhage (aSAH) face challenges returning to work, with fatigue being a major predictor of no return. Addressing fatigue is crucial for successful work integration after aSAH.

Keywords:
aneurysm repairaneurysmal subarachnoid hemorrhagefatiguelong term follow-upoutcomepoor grade aneurysmal SAHreturn to work

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Area of Science:

  • Neurosurgery
  • Neurology
  • Occupational Health

Background:

  • Survivors of aneurysmal subarachnoid hemorrhage (aSAH) often experience good physical and cognitive recovery.
  • However, a significant proportion of aSAH survivors do not return to productive employment.
  • Predictors for return to work (RTW) after aSAH remain poorly understood and debated.

Purpose of the Study:

  • To determine the rate of return to maximum work capacity up to 5 years post-ictus in a large cohort of aSAH patients.
  • To identify demographic and medical predictors associated with not returning to work after aSAH.

Main Methods:

  • Prospective data collection from 500 aSAH survivors (aged >18) treated between 2012-2018.
  • Assessment included work status, demographics, aSAH severity (ICH, WFNS grade), aneurysm repair method, and complications (vasospasm, infarction, hydrocephalus).
  • RTW was evaluated in 299 employed patients, with fatigue levels also registered.

Main Results:

  • 51.2% of previously employed patients returned to gainful employment; 32.4% achieved complete RTW.
  • Independent predictors for no RTW included older age, WFNS grade 3, and active smoking.
  • Clinically significant fatigue was the strongest predictor, increasing no RTW risk fivefold; higher education correlated with increased RTW chance.

Conclusions:

  • Fatigue is a critical factor impacting return to work integration for aSAH survivors.
  • While aSAH severity and WFNS grade play a role, neurological motor deficits may be more closely linked to no RTW.
  • Educational background positively influences RTW prospects.