• Neurocritical care · Dec 2012

    Trajectory of functional recovery after hospital discharge for subarachnoid hemorrhage.

    • Babak B Navi, Hooman Kamel, J Claude Hemphill, and Wade S Smith.
    • Department of Neurology and Neuroscience, Weill Cornell Medical College, 525 East 68th Street, New York, NY, USA. ban9003@med.cornell.edu
    • Neurocrit Care. 2012 Dec 1;17(3):343-7.

    BackgroundAlthough there are extensive data on long-term disability after subarachnoid hemorrhage (SAH), there are few data on the trajectory of functional recovery after hospital discharge.MethodsFrom October 2009 to April 2010, we prospectively followed consecutive patients with non-traumatic SAH discharged from a university hospital. Modified Rankin Scale (mRS) scores were calculated at discharge from chart review and at 6 months by standardized telephone interview. Good functional status was defined as a mRS score of 0-2, and poor status as an mRS score of 3-6. Descriptive statistics were used to assess the trajectory of functional recovery and determine the proportion of patients whose functional status improved from poor to good.ResultsAmong 52 patients with non-traumatic SAH (79 % aneurysmal) who were discharged alive, most (71 %) were discharged home. Median (IQR) mRS score was 3 (2-4) at discharge and 2 (1-2) at 6 months. Some functional recovery (any improvement in mRS score) was seen in most patients (83 %; 95 % CI, 72-93 %). Of the 28 patients with poor functional status at discharge, 16 (57 %) improved to good functional status at 6 months. All patients with Hunt-Hess grade 4 or 5 hemorrhages (n = 14) had poor functional status at discharge, but half (95 % CI, 20-80 %) recovered to a good functional status at 6 months.ConclusionsAlthough our sample size is small, our findings suggest that a substantial proportion of patients with SAH who are disabled at discharge go on to regain functional independence within 6 months.

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