Abstract

The rate of mortality and disability associated with aneurysmal subarachnoid hemorrhage (SAH) is high. Patients with multiple cerebral aneurysms (MCA) require repeated surgeries more often and they are likely to develop aneurysms de novo and suffer their rupture. This study aimed to apply the International Classification of Functioning (ICF) to assess the quality of life (QOL) of MCA patients after endovascular treatment, late postoperative period. The study involved patients who underwent endovascular treatment and had multiple (>2) cerebral aneurysms (141 people). All patients underwent 1–6 endovascular surgeries; complications developed in 7.1% (10/141) of cases. The patients' QOL was assessed against the ICF 6 to 24 months post-surgery. We found that at such time points treatment results deteriorate in a number of domains, namely those associated with pain, memory, motor coordination, limb strength. Patients with ruptured aneurysms showed worse results for locomotion-related domains than patients with unruptured aneurysms (p < 0.05), in patients with aneurysms having a pseudotumor type of flow, by domains associated with dysfunction of the cranial nerves responsible for innervation of the eye muscles (p < 0.001) (p < 0.001). Patients with ruptured MCA were more active in the late post-surgery period, which was revealed by comparing that period's data to the baseline pre-surgery records (p < 0.05). The severity of activity disorders depended on surgery complications, patient age (p < 0.05), complications that developed during the acute SAH stage (p < 0.001).

Highlights

  • The rate of mortality and disability associated with aneurysmal subarachnoid hemorrhage (SAH) is high

  • The International Classification of Functioning (ICF) allows a systematic assessment of the state of body functions, with a single impairments severity scale; we established that the scores registered in the pain (b28010) and memory function (b144) domains were low more often than those describing the status in the voluntary movements coordination (b7602) and muscle power (b7302) domains

  • Assessing the impairments detected in the late postsurgery period through the lens of pre-surgery aneurysm development pattern, we established that we found that in patients with ruptured aneurysms, the movement (b 7302, d4602, d640) domains indicators were significantly worse compared to the other types of multiple aneurysms development patterns (p < 0.05)

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Summary

Introduction

The rate of mortality and disability associated with aneurysmal subarachnoid hemorrhage (SAH) is high. Patients with multiple cerebral aneurysms (MCA) require repeated surgeries more often and they are likely to develop aneurysms de novo and suffer their rupture. This study aimed to apply the International Classification of Functioning (ICF) to assess the quality of life (QOL) of MCA patients after endovascular treatment, late postoperative period. The study involved patients who underwent endovascular treatment and had multiple (>2) cerebral aneurysms (141 people). Целью исследования было оценить качество жизни (КЖ) пациентов с помощью Международной классификации функционирования (МКФ) в отдаленном послеоперационном периоде после эндоваскулярного лечения МА для определения пути оптимизации реабилитации. Что в отдаленном послеоперационном периоде результаты были хуже по доменам, связанным с болью, памятью, координацией движений, силой конечностей. По сравнению с показателями дооперационного периода в отдаленном послеоперационном периоде выявлено повышение активности и участия больных с геморрагическим типом течения (p < 0,05). Ключевые слова: множественные церебральные аневризмы, качество жизни, эндоваскулярное лечение, отдаленные результаты лечения аневризм, оптимизация медицинской реабилитации

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