Late results and health-related quality of life in patients after endovascular treatment for multiple intracranial aneurysms

Abstract

Aim. To assess the results of endovascular treatment in patients with multiple intracranial aneurysms (MIA) in the late postoperative period according to health-related quality of life (HRQoL) concept. Materials and methods . 172 cases of patients having undergone endovascular MIA repair were examined. The evaluation of patient health-related quality of life was carried out using the SF-36 (The Short Form ( 36 ) Health Survey), the ICF (the International Classification of Functioning), and the modified Rankin Scale (mRS). Results . The complication of subarachnoid hemorrhage ( SAH ) appears in approximately 1,2% of cases in the late postoperative period. When assessing the health-related quality of life according to the SF-36 domains in patients with Subarachnoid hemorrhage (SAH), the QoL showed a decrease in “Social Functioning” ( p = 0.03) . In patients with pseudotumor cerebri (PTC) a decrease was seen in “ Role-Physical Functioning” (RP) ( p = 0.004), while “General Health” (GH) ( p = 0.049), “Social Functioning” (SF) ( p = 0.005) and “Mental Health” (MH) ( p = 0.009) subscales also saw decreases. Having more than two inpatient surgical procedures is also associated with the health-related quality of life of patients ( p < 0.05). Assessment of activity with ICF showed the intensity of irregularities on the d4501 domain – “walking short distance” – depended on the existing SAH ( p < 0.05). Procedural complications affected the patient’s daily activities on the domains d4501 — “walking long distance” ( p = 0.03), and d640 — “doing household chores” ( p = 0.01). Conclusion . The assessment with ICF allows the specification of patient activity and participation in public life. The SF-36 scale provides additional information on the patients’ subjective perception of their condition. Considering the quality of life in the late postoperative period is not completely restored in all patients, ongoing rehabilitation measures, diagnostic cerebral angiographies and improvements in the surgery techniques are required.