Long-term quality of life and depressive symptoms among survivors of poor-grade aneurysmal subarachnoid hemorrhage.
- 1Department of Neurosurgery, Düsseldorf University Hospital, Heinrich-Heine University Düsseldorf, Düsseldorf, North Rhine-Westphalia, 40225, Germany.
Abstract
Introduction
Poor-grade aneurysmal subarachnoid hemorrhage (aSAH) is associated with high mortality and poor functional outcomes. Despite improved survival with advances in neurocritical care, long-term quality of life (QOL) and psychological sequelae remain insufficiently characterized.Research question
What is the long-term quality of life among survivors of poor-grade aSAH and how is it associated with functional and psychological outcomes?Material and methods
We retrospectively analyzed patients with poor-grade aSAH (WFNS IV-V) treated between 2013 and 2023. Survivors underwent long-term follow-up assessment using the Stroke-Specific Quality of Life scale (SS-QOL), SF-12 Physical Component Summary (PCS), and Patient Health Questionnaire (PHQ-9). SS-QOL >147 was used as descriptive threshold.Results
Of 339 patients with poor-grade aSAH, 47.8% died. Among survivors, 15.9% were lost to follow-up. Among eligible survivors, 35.8% did not participate, resulting in 79 included patients (23.3% of the original cohort; median follow-up of 4.36 years. Among participants, 88.6% had SS-QOL >147. SS-QOL correlated positively with SF-12 PCS (ρ = 0.49, p < 0.001) and negatively with PHQ-9 (ρ = -0.67, p < 0.001). In multivariable analysis, PHQ-9 was the only variable associated with SS-QOL. Higher depressive symptom burden was associated with lower scores across all SS-QOL domains.Discussion and conclusion
Among selected survivors of poor-grade aSAH, favorable QOL was observed despite severe initial disease. Depressive symptom burden was strongly associated with overall QOL, and inversely associated with all SS-QOL domains. However, mortality, loss to follow-up, and non-participation represent sources of selection bias and may result in overestimation of QOL.
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BibTeX
@article{david2026longterm,
title = {{Long-term quality of life and depressive symptoms among survivors of poor-grade aneurysmal subarachnoid hemorrhage.}},
author = {Isabel David and Ibrahim E Efe and Igor Fischer and David Wasilewski and Sihmehmet Sahan and Yousef Abusabha and Milad Neyazi and Rajiv Kumar Khajuria and Katharina Faust and Sajjad Muhammad},
journal = {Brain \& spine},
year = {2026},
month = oct,
doi = {10.1016/j.bas.2026.107465},
url = {https://europepmc.org/article/MED/42903676},
note = {CC BY},
}
RIS
TY - JOUR
TI - Long-term quality of life and depressive symptoms among survivors of poor-grade aneurysmal subarachnoid hemorrhage.
AU - Isabel David
AU - Ibrahim E Efe
AU - Igor Fischer
AU - David Wasilewski
AU - Sihmehmet Sahan
AU - Yousef Abusabha
AU - Milad Neyazi
AU - Rajiv Kumar Khajuria
AU - Katharina Faust
AU - Sajjad Muhammad
PY - 2026
DA - 2026/10/09
JO - Brain & spine
DO - 10.1016/j.bas.2026.107465
UR - https://europepmc.org/article/MED/42903676
AB - Introduction Poor-grade aneurysmal subarachnoid hemorrhage (aSAH) is associated with high mortality and poor functional outcomes. Despite improved survival with advances in neurocritical care, long-term quality of life (QOL) and psychological sequelae remain insufficiently characterized.Research question What is the long-term quality of life among survivors of poor-grade aSAH and how is it associated with functional and psychological outcomes?Material and methods We retrospectively analyzed patients with poor-grade aSAH (WFNS IV-V) treated between 2013 and 2023. Survivors underwent long-term follow-up assessment using the Stroke-Specific Quality of Life scale (SS-QOL), SF-12 Physical Component Summary (PCS), and Patient Health Questionnaire (PHQ-9). SS-QOL >147 was used as descriptive threshold.Results Of 339 patients with poor-grade aSAH, 47.8% died. Among survivors, 15.9% were lost to follow-up. Among eligible survivors, 35.8% did not participate, resulting in 79 included patients (23.3% of the original cohort; median follow-up of 4.36 years. Among participants, 88.6% had SS-QOL >147. SS-QOL correlated positively with SF-12 PCS (ρ = 0.49, p < 0.001) and negatively with PHQ-9 (ρ = -0.67, p < 0.001). In multivariable analysis, PHQ-9 was the only variable associated with SS-QOL. Higher depressive symptom burden was associated with lower scores across all SS-QOL domains.Discussion and conclusion Among selected survivors of poor-grade aSAH, favorable QOL was observed despite severe initial disease. Depressive symptom burden was strongly associated with overall QOL, and inversely associated with all SS-QOL domains. However, mortality, loss to follow-up, and non-participation represent sources of selection bias and may result in overestimation of QOL.
SN - 2772-5294
ER -