• Verena Rass, Klaus Altmann, Laura Zamarian, Anna Lindner, Mario Kofler, Max Gaasch, Bogdan-Andrei Ianosi, Lauma Putnina, Philipp Kindl, Margarete Delazer, Alois J Schiefecker, Ronny Beer, Bettina Pfausler, and Raimund Helbok.
• Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
• Neurocrit Care. 2023 Dec 21.

BackgroundPatients with spontaneous subarachnoid hemorrhage (SAH) frequently encounter cognitive dysfunction and mental health issues with negative effects on health-related quality of life (HR-QoL). Here, we aimed to describe the prevalence of cognitive deficits, mental health problems, and HR-QoL impairments 1 year after SAH.MethodsIn this prospective observational study, 177 patients with SAH admitted to our neurointensive care unit over a time span of ten years followed the invitation for an in-person 1-year follow-up, including a standardized neuropsychological test battery. Mental health issues (anxiety and depression) and HR-QoL were evaluated using questionnaires (Hospital Anxiety and Depression Scale; 36-item Short Form questionnaire). Functional outcome was assessed with the modified Rankin Scale (mRS) score.ResultsPatients were 54 years of age (interquartile range 47-62 years) and presented with a median Hunt and Hess score of 2 (interquartile range 1-3) at admission. Most patients (93%) achieved good functional 1-year outcomes (mRS score 0-2). Seventy-one percent of patients had deficits in at least one cognitive domain, with memory deficits being the most prevalent (51%), followed by deficits in executive functions (36%), visuoconstruction (34%), and attention (21%). Even patients with perimesencephalic SAH (18%) or with full functional recovery (mRS score = 0, 46%) had a comparable prevalence of cognitive deficits (61% and 60%, respectively). Symptoms of depression and anxiety were reported by 16% and 33% of patients, respectively. HR-QoL was impaired in 37% (55 of 147). Patients with cognitive deficits (p = 0.001) or mental health issues (p < 0.001) more frequently reported impaired HR-QoL.ConclusionsMost patients with SAH have cognitive deficits and mental health issues 1 year after SAH. These deficits impair patients' quality of life.© 2023. The Author(s).

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