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Open Access 01-12-2024 | Subarachnoid Hemorrhage | Original Article

Evaluation of FRESH scores in predicting outcome and quality of life after aneurysmal subarachnoid haemorrhage in a European patient cohort

Authors: Björn B. Hofmann, Evgenia P. Gundlach, Igor Fischer, Sajjad Muhammad, Rainer Kram, Kerim Beseoglu, Jan F. Cornelius

Published in: Acta Neurochirurgica | Issue 1/2024

Abstract

Background

Despite aneurysmal subarachnoid haemorrhage (aSAH) patients often experiencing physical and mental disabilities impacting their quality of life (QoL), routine assessment of long-term QoL data and predictive tools are limited. This study evaluates the newly developed “functional recovery expected after subarachnoid haemorrhage” (FRESH) scores with long-term outcomes and QoL in European aSAH patients.

Methods

FRESH, FRESH-cog, and FRESH-quol scores were retrospectively obtained from aSAH patients. Patients were contacted, and the modified Rankin Scale (mRS), extended short form-36 (SF-36), and telephone interview for cognitive status (TICS) were collected and performed. The prognostic and empirical outcomes were compared.

Results

Out of 374 patients, 171 patients (54.1%) completed the SF-36, and 154 patients completed the TICS. The SF-36 analysis showed that 32.7% had below-average physical component summary (PCS) scores, and 39.8% had below-average mental component summary (MCS) scores. There was no significant correlation between the FRESH score and PCS (p = 0.09736), MCS (p = 0.1796), TICS (p = 0.7484), or mRS 10–82 months (average 46 months) post bleeding (p = 0.024), respectively. There was also no significant correlation found for “FRESH-cog vs. TICS” (p = 0.0311), “FRESH-quol vs. PCS” (p = 0.0204), “FRESH-quol vs. MCS” (p = 0.1361) and “FRESH-quol vs. TICS” (p = 0.1608).

Conclusions

This study found no correlation between FRESH scores and validated QoL tools in a European population of aSAH patients. The study highlights the complexity of reliable long-term QoL prognostication in aSAH patients and emphasises the need for further prospective research to also focus on QoL as an important outcome parameter.

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Brandt J, Spencer M, Folstein M (1988) The telephone interview for cognitive status. Neuropsychiatry Neuropsychol Behav Neurol 1:111–117

Bullinger M (1995) German translation and psychometric testing of the SF-36 health survey: preliminary results from the IQOLA project. Soc Sci Med 41:1359–1366CrossRefPubMed

Bullinger M (1996) Assessment of health related quality of life with the SF-36 health survey. Rehabilitation (Stuttg) 35:XVII–XXVIIPubMed

CG D (1988) Report of World Federation of Neurological Surgeons Committee on a Universal Subarachnoid Hemorrhage Grading Scale. J Neurosurg 68:985–986. https://doi.org/10.3171/jns.1988.68.6.0985CrossRef

Connolly ES Jr, Rabinstein AA, Carhuapoma JR, Derdeyn CP, Dion J, Higashida RT, Hoh BL, Kirkness CJ, Naidech AM, Ogilvy CS, Patel AB, Thompson BG, Vespa P (2012) Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/american Stroke Association. Stroke 43:1711–1737. https://doi.org/10.1161/STR.0b013e3182587839CrossRefPubMed

Ellert U, Kurth BM (2013) Gesundheitsbezogene Lebensqualität bei Erwachsenen in Deutschland. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 56:643–649. https://doi.org/10.1007/s00103-013-1700-yCrossRef

Etminan N, Beseoglu K, Heiroth HJ, Turowski B, Steiger HJ, Hanggi D (2013) Early perfusion computerized tomography imaging as a radiographic surrogate for delayed cerebral ischemia and functional outcome after subarachnoid hemorrhage. Stroke 44:1260–1266. https://doi.org/10.1161/strokeaha.111.675975CrossRefPubMed

Fong TG, Fearing MA, Jones RN, Shi P, Marcantonio ER, Rudolph JL, Yang FM, Kiely DK, Inouye SK (2009) Telephone interview for cognitive status: creating a crosswalk with the mini-mental state examination. Alzheimers Dement 5:492–497CrossRefPubMed

Gaastra B, Ewbank F, Tapper W, Bulters D, Galea I (2022) Long-term cognitive outcome following aneurysmal subarachnoid haemorrhage. J Stroke Cerebrovasc Dis 31:106184. https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106184CrossRefPubMed

10.

Hijdra A, Van Gijn J, Nagelkerke NJ, Vermeulen M, Van Crevel H (1988) Prediction of delayed cerebral ischemia, rebleeding, and outcome after aneurysmal subarachnoid hemorrhage. Stroke 19:1250–1256CrossRefPubMed

11.

Hofmann BB, Fischer I, Donaldson DM, Abusabha Y, Karadag C, Muhammad S, Beseoglu K, Hänggi D, Turowski B, Rubbert C, Cornelius JF, Kamp MA (2023) Evaluation of MTT heterogeneity of perfusion CT imaging in the early brain injury phase: an insight into aSAH pathopysiology. Brain Sci 13:824. https://doi.org/10.3390/brainsci13050824CrossRefPubMedPubMedCentral

12.

Hofmann BB, Donaldson DM, Fischer I, Karadag C, Neyazi M, Piedade GS, Abusabha Y, Muhammad S, Rubbert C, Hänggi D, Beseoglu K (2023) Blood pressure affects the early CT perfusion imaging in patients with aSAH reflecting early disturbed autoregulation. Neurocrit Care. https://doi.org/10.1007/s12028-023-01683-8

13.

Hofmann BB, Fischer I, Engel A, Jannusch K, Donaldson DM, Karadag C, van Lieshout JH, Beseoglu K, Muhammad S, Turowski B, Hänggi D, Kamp MA, Rubbert C (2021) MTT heterogeneity in perfusion CT imaging as a predictor of outcome after aneurysmal SAH. AJNR Am J Neuroradiol. https://doi.org/10.3174/ajnr.A7169

14.

Hofmann BB, Fischer I, Neyazi M, Karadag C, Donaldson DM, Abusabha Y, Muhammad S, Beseoglu K, Cornelius JF, Hänggi D (2023) Revisiting the WFNS score: native computed tomography imaging improves identification of patients with "false poor grade" aneurysmal subarachnoid hemorrhage. Neurosurgery. https://doi.org/10.1227/neu.0000000000002715

15.

Hua X, Gray A, Wolstenholme J, Clarke P, Molyneux AJ, Kerr RSC, Clarke A, Sneade M, Rivero-Arias O (2021) 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. Neurosurgery 88:252–260. https://doi.org/10.1093/neuros/nyaa454CrossRefPubMed

16.

Inagawa T, Yamamoto M, Kamiya K, Ogasawara H (1988) Management of elderly patients with aneurysmal subarachnoid hemorrhage. J Neurosurg 69:332–339. https://doi.org/10.3171/jns.1988.69.3.0332CrossRefPubMed

17.

Jaja BNR, Cusimano MD, Etminan N, Hanggi D, Hasan D, Ilodigwe D, Lantigua H, Le Roux P, Lo B, Louffat-Olivares A (2013) Clinical prediction models for aneurysmal subarachnoid hemorrhage: a systematic review. Neurocrit Care 18:143–153CrossRefPubMed

18.

Jaja BNR, Saposnik G, Lingsma HF, Macdonald E, Thorpe KE, Mamdani M, Steyerberg EW, Molyneux A, Manoel ALO, Schatlo B, Hanggi D, Hasan D, Wong GKC, Etminan N, Fukuda H, Torner J, Schaller KL, Suarez JI, Stienen MN et al (2018) Development and validation of outcome prediction models for aneurysmal subarachnoid haemorrhage: the SAHIT multinational cohort study. BMJ 360:j5745. https://doi.org/10.1136/bmj.j5745CrossRefPubMed

19.

Knaus WA, Zimmerman JE, Wagner DP, Draper EA, Lawrence DE (1981) APACHE—acute physiology and chronic health evaluation: a physiologically based classification system. Crit Care Med 9:591–597CrossRefPubMed

20.

Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) APACHE II: a severity of disease classification system. Crit Care Med 13:818–829CrossRefPubMed

21.

Lee VH, Ouyang B, John S, Conners JJ, Garg R, Bleck TP, Temes RE, Cutting S, Prabhakaran S (2014) Risk stratification for the in-hospital mortality in subarachnoid hemorrhage: the HAIR score. Neurocrit Care 21:14–19CrossRefPubMed

22.

Lins L, Carvalho FM (2016) SF-36 total score as a single measure of health-related quality of life: scoping review. SAGE Open Med 4:2050312116671725CrossRefPubMedPubMedCentral

23.

Morfeld M, Kirchberger I, Bullinger M (2011) SF-36 Fragebogen zum Gesundheitszustand: Deutsche version des short Form-36 health survey. Hogrefe

24.

Nussbaum ES, Mikoff N, Paranjape GS (2021) Cognitive deficits among patients surviving aneurysmal subarachnoid hemorrhage. A contemporary systematic review. Br J Neurosurg 35:384–401. https://doi.org/10.1080/02688697.2020.1859462CrossRefPubMed

25.

Pegoli M, Mandrekar J, Rabinstein AA, Lanzino G (2015) Predictors of excellent functional outcome in aneurysmal subarachnoid hemorrhage. J Neurosurg 122:414–418. https://doi.org/10.3171/2014.10.JNS14290CrossRefPubMed

26.

Petridis AK, Kamp MA, Cornelius JF, Beez T, Beseoglu K, Turowski B, Steiger HJ (2017) Aneurysmal subarachnoid hemorrhage. Dtsch Arztebl Int 114:226–236. https://doi.org/10.3238/arztebl.2017.0226CrossRefPubMed

27.

Rinkel GJE, Algra A (2011) Long-term outcomes of patients with aneurysmal subarachnoid haemorrhage. Lancet Neurol 10:349–356. https://doi.org/10.1016/S1474-4422(11)70017-5CrossRefPubMed

28.

Suarez JI, Tarr RW, Selman WR (2006) Aneurysmal subarachnoid hemorrhage. N Engl J Med 354:387–396. https://doi.org/10.1056/NEJMra052732CrossRefPubMed

29.

Taufique Z, May T, Meyers E, Falo C, Mayer SA, Agarwal S, Park S, Connolly ES, Claassen J, Schmidt JM (2016) Predictors of poor quality of life 1 year after subarachnoid hemorrhage. Neurosurgery 78:256–264CrossRefPubMed

30.

van Donkelaar CE, Bakker NA, Birks J, Veeger NJGM, Metzemaekers JDM, Molyneux AJ, Groen RJM, van Dijk JMC (2019) Prediction of outcome after aneurysmal subarachnoid hemorrhage. Stroke 50:837–844. https://doi.org/10.1161/STROKEAHA.118.023902CrossRefPubMed

31.

Vilkki J, Juvela S, Malmivaara K, Siironen J, Hernesniemi J (2012) Predictors of work status and quality of life 9–13 years after aneurysmal subarachnoid hemorrahage. Acta Neurochir 154:1437–1446CrossRefPubMed

32.

Visser-Meily JMA, Rhebergen ML, Rinkel GJE, van Zandvoort MJ, Post MWM (2009) Long-term health-related quality of life after aneurysmal subarachnoid hemorrhage: relationship with psychological symptoms and personality characteristics. Stroke 40:1526–1529CrossRefPubMed

33.

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP (2007) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370:1453–1457. https://doi.org/10.1016/s0140-6736(07)61602-xCrossRef

34.

Ware JE Jr, Gandek B (1998) Overview of the SF-36 health survey and the international quality of life assessment (IQOLA) project. J Clin Epidemiol 51:903–912CrossRefPubMed

35.

Witsch J, Frey HP, Patel S, Park S, Lahiri S, Schmidt JM, Agarwal S, Falo MC, Velazquez A, Jaja B (2016) Prognostication of long-term outcomes after subarachnoid hemorrhage: the FRESH score. Ann Neurol 80:46–58CrossRefPubMed

36.

Witsch J, Kuohn L, Hebert R, Cord B, Sansing L, Gilmore EJ, Hwang DY, Petersen N, Falcone GJ, Matouk C (2019) Early prognostication of 1-year outcome after subarachnoid hemorrhage: the FRESH score validation. J Stroke Cerebrovasc Dis 28:104280CrossRefPubMed

37.

Wong GKC, Poon WS, Boet R, Chan MTV, Gin T, Ng SCP, Zee BCY (2011) Health-related quality of life after aneurysmal subarachnoid hemorrhage: profile and clinical factors. Neurosurgery 68:1556–1561CrossRefPubMed

Title: Evaluation of FRESH scores in predicting outcome and quality of life after aneurysmal subarachnoid haemorrhage in a European patient cohort
Authors: Björn B. Hofmann
Evgenia P. Gundlach
Igor Fischer
Sajjad Muhammad
Rainer Kram
Kerim Beseoglu
Jan F. Cornelius
Publication date: 01-12-2024
Publisher: Springer Vienna
Keywords: Subarachnoid Hemorrhage
Subarachnoid Hemorrhage
Published in: Acta Neurochirurgica / Issue 1/2024
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-024-05909-2

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Springer Medicine

Evaluation of FRESH scores in predicting outcome and quality of life after aneurysmal subarachnoid haemorrhage in a European patient cohort

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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