Ppn14: a prognostic model to predict quality of life chances after subarachnoid hemorrhage

OBJECTIVES: Traditionally, mainly survival chances are considered at clinical decisions before major operations. This study looked at the potential ability of the most commonly used pre-operation estimators to predict health related quality of life of subarachnoid hemorrhage (SAH) patients one year after surgery. METHODS: 173 patients underwent intracranial aneurysm surgery within 72 hours after SAH at the National Institute of Neurosurgery in 1998 and1999. Before surgery health status assessment included Hunt-Hess (HH) grade as a measure of neurological status, ASA physical status score, and CT examination that determines the presence of intracerebral hemorrhage (ICH) and Fisher scale. 12 months after the surgery, patients were interviewed either by phone or post by using the EQ-5D generic quality of life questionnaire. The relationship between the pre-operation health status/risk estimators and one-year QoL values was examined by differences in mean EQ-5Dindex values and by developing a regression model. F-statistics and student-t tests have been used to test statistical significance. RESULTS: Patients with ICH had lower EQ-5D index values (0.32 vs. 0.70, p 3 had lower QoL than those with scores below (0.35 vs. 0.68, p 3 lead to lower QoL values (0.05 vs. 0.66, p 2 had also significantly lower QoL (0.18 vs. 0.66, p 2) °V 0.24fxICH °V 0.30fx(HH> 3) °V 0.006fxAGE. The overall model showed an R2 = 0.412, and p-value <0.001. P-values for individual coefficients were 0.0001, 0.0001, 0.0001, 0.002, and 0.012, respectively. CONCLUSIONS: Pre-operation health status/risk assessment can predict future quality of life to an important extent. It is argued that QoL chances should also be considered in addition to survival chances. These results can be useful in sub-group analyses in modeling studies.