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

BackgroundPatients with aneurysmal subarachnoid hemorrhage (aSAH) have poor outcome. Studies on outcome beyond 1year post-aSAH are few, and late recovery is poorly investigated, initiating this prospective outcome study on patients 12-15years after an aSAH. We hypothesized to find; functional improvement>1year post-ictus; increased long-term mortality in aSAH patients vs matched controls, and finally to present; predictors of long-term favorable outcome (GOS 4-5). MethodsWe prospectively investigated patients, admitted 2000-2003 to the Sahlgrenska University Hospital, 1year post-ictus using Glasgow Outcome Scale (GOS). The patients were revalidated 12-15years post-aSAH by structured-telephone interviews (GOS), followed by statistical analysis. ResultsA total of 158 patients were included, (women n=114, men n=44), with a mean age of 55years at aSAH. Patients treated with surgical clipping had lower mortality. At the follow-up 12-15years post-aSAH, all 103 survivors (65.2%) were categorized as having; good recovery (39.9%), moderate disability (15.2%), or severe disability (10.1%). Within the patient cohort, 23.6% improved GOS over time. Fifty-five patients died, median at 4years post-ictus. aSAH patients had 3.5 times increased mortality 12-15years post-ictus vs matched controls (P<.0001). Patients with favorable outcome at 1year (67.3%, n=101) had similar survival probability as control patients. Prognostic indicators of long-term favorable outcome were low age and high GOS at 1-year follow-up, (AUCROC, 0.79). ConclusionsIndividual functional improvement was found >1year post-ictus. Patients with favorable outcome at 1year had similar long-term life expectancy as the general population. Indicators of long-term favorable prognosis were low age at ictus and high GOS at 1-year follow-up.