• Johannes Goldberg, Werner J Z'Graggen, Martin Hlavica, Mattia Branca, Serge Marbacher, Donato D'Alonzo, Javier Fandino, Martin N Stienen, Marian C Neidert, Jan-Karl Burkhardt, Luca Regli, Martin Seule, Michel Roethlisberger, Raphael Guzman, Daniel Walter Zumofen, Rodolfo Maduri, Roy Thomas Daniel, Amir El Rahal, Marco V Corniola, Philippe Bijlenga, Karl Schaller, Roland Rölz, Christian Scheiwe, Mukesch Shah, Dieter Henrik Heiland, Oliver Schnell, Jürgen Beck, Andreas Raabe, and Christian Fung.
• Department of Neurosurgery, Inselspital, Bern University-Hospital, Bern, Switzerland.
• Neurosurgery. 2023 May 1; 92 (5): 105210571052-1057.

BackgroundPoor-grade aneurysmal subarachnoid hemorrhage (aSAH) is associated with high mortality and poor disability outcome. Data on quality of life (QoL) among survivors are scarce because patients with poor-grade aSAH are underrepresented in clinical studies reporting on QoL after aSAH.ObjectiveTo provide prospective QoL data on survivors of poor-grade aSAH to aid clinical decision making and counseling of relatives.MethodsThe herniation World Federation of Neurosurgical Societies scale study was a prospective observational multicenter study in patients with poor-grade (World Federation of Neurosurgical Societies grades 4 & 5) aSAH. We collected data during a structured telephone interview 6 and 12 months after ictus. QoL was measured using the EuroQoL - 5 Dimensions - 3 Levels (EQ-5D-3L) questionnaire, with 0 representing a health state equivalent to death and 1 to perfect health. Disability outcome for favorable and unfavorable outcomes was measured with the modified Rankin Scale.ResultsTwo hundred-fifty patients were enrolled, of whom 237 were included in the analysis after 6 months and 223 after 12 months. After 6 months, 118 (49.8%) patients were alive, and after 12 months, 104 (46.6%) patients were alive. Of those, 95 (80.5%) and 89 (85.6%) reached a favorable outcome with mean EQ-5D-3L index values of 0.85 (±0.18) and 0.86 (±0.18). After 6 and 12 months, 23 (19.5%) and 15 (14.4%) of those alive had an unfavorable outcome with mean EQ-5D-3L index values of 0.27 (±0.25) and 0.19 (±0.14).ConclusionDespite high initial mortality, the proportion of poor-grade aSAH survivors with good QoL is reasonably large. Only a minority of survivors reports poor QoL and requires permanent care.Copyright © Congress of Neurological Surgeons 2023. All rights reserved.

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