Predictors of global cognitive impairment 1 year after subarachnoid hemorrhage

Mellanie V. Springer, J. Michael Schmidt, Katja E. Wartenberg, Jennifer A. Frontera, Neeraj Badjatia, Stephan A. Mayer

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

OBJECTIVE: We sought to determine the frequency, risk factors, and impact on functional outcome and quality of life (QOL) of global cognitive impairment 1 year after subarachnoid hemorrhage. METHODS: We prospectively evaluated global cognitive status 3 and 12 months after hospitalization with the Telephone Interview for Cognitive Status in 232 subarachnoid hemorrhage survivors. Cognitive impairment was defined as a score of 30 or less (scaled 0 = worst, 51 = best). Logistic regression was performed to calculate adjusted odds ratios (AORs) for impairment at 1 year. Basic activities of daily living were evaluated with the Barthel Index, instrumental activities of daily living were assessed with the Lawton scale, and QOL was evaluated with the Sickness Impact Profile. RESULTS: The frequency of cognitive impairment was 27% at 3 months and 21% at 12 months. After the effects of age, education, and race/ethnicity were controlled for, risk factors for cognitive impairment at 12 months included anemia treated with transfusion (AOR, 3.4; P = 0.006), any temperature level higher than 38.6°C (AOR, 2.7; P = 0.016), and delayed cerebral ischemia (AOR, 3.6; P = 0.01). Among cognitively impaired patients at 3 months, improvement at 1 year occurred in 34% and was associated with more than 12 years of education and the absence of fever higher than 38.6°C during hospitalization (P = 0.015). Patients with cognitive impairment at 1 year had worse concurrent QOL and less ability to perform instrumental and basic activities of daily living (all P < 0.001). CONCLUSION: Global cognitive impairment affects more than 20% of subarachnoid hemorrhage survivors at 1 year, is predicted by fever, anemia treated with transfusion, and delayed cerebral ischemia, and adversely affects functional recovery and QOL.

Original languageEnglish (US)
Pages (from-to)1043-1050
Number of pages8
JournalNeurosurgery
Volume65
Issue number6
DOIs
StatePublished - Dec 2009

Fingerprint

Subarachnoid Hemorrhage
Activities of Daily Living
Odds Ratio
Quality of Life
Brain Ischemia
Survivors
Anemia
Hospitalization
Fever
Sickness Impact Profile
Education
Aptitude
Cognitive Dysfunction
Logistic Models
Interviews
Temperature

Keywords

  • Anemia
  • Cerebral aneurysm
  • Cognitive impairment
  • Delayed cerebral ischemia
  • Fever
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Springer, M. V., Schmidt, J. M., Wartenberg, K. E., Frontera, J. A., Badjatia, N., & Mayer, S. A. (2009). Predictors of global cognitive impairment 1 year after subarachnoid hemorrhage. Neurosurgery, 65(6), 1043-1050. https://doi.org/10.1227/01.NEU.0000359317.15269.20

Predictors of global cognitive impairment 1 year after subarachnoid hemorrhage. / Springer, Mellanie V.; Schmidt, J. Michael; Wartenberg, Katja E.; Frontera, Jennifer A.; Badjatia, Neeraj; Mayer, Stephan A.

In: Neurosurgery, Vol. 65, No. 6, 12.2009, p. 1043-1050.

Research output: Contribution to journalArticle

Springer, MV, Schmidt, JM, Wartenberg, KE, Frontera, JA, Badjatia, N & Mayer, SA 2009, 'Predictors of global cognitive impairment 1 year after subarachnoid hemorrhage', Neurosurgery, vol. 65, no. 6, pp. 1043-1050. https://doi.org/10.1227/01.NEU.0000359317.15269.20
Springer MV, Schmidt JM, Wartenberg KE, Frontera JA, Badjatia N, Mayer SA. Predictors of global cognitive impairment 1 year after subarachnoid hemorrhage. Neurosurgery. 2009 Dec;65(6):1043-1050. https://doi.org/10.1227/01.NEU.0000359317.15269.20
Springer, Mellanie V. ; Schmidt, J. Michael ; Wartenberg, Katja E. ; Frontera, Jennifer A. ; Badjatia, Neeraj ; Mayer, Stephan A. / Predictors of global cognitive impairment 1 year after subarachnoid hemorrhage. In: Neurosurgery. 2009 ; Vol. 65, No. 6. pp. 1043-1050.
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abstract = "OBJECTIVE: We sought to determine the frequency, risk factors, and impact on functional outcome and quality of life (QOL) of global cognitive impairment 1 year after subarachnoid hemorrhage. METHODS: We prospectively evaluated global cognitive status 3 and 12 months after hospitalization with the Telephone Interview for Cognitive Status in 232 subarachnoid hemorrhage survivors. Cognitive impairment was defined as a score of 30 or less (scaled 0 = worst, 51 = best). Logistic regression was performed to calculate adjusted odds ratios (AORs) for impairment at 1 year. Basic activities of daily living were evaluated with the Barthel Index, instrumental activities of daily living were assessed with the Lawton scale, and QOL was evaluated with the Sickness Impact Profile. RESULTS: The frequency of cognitive impairment was 27{\%} at 3 months and 21{\%} at 12 months. After the effects of age, education, and race/ethnicity were controlled for, risk factors for cognitive impairment at 12 months included anemia treated with transfusion (AOR, 3.4; P = 0.006), any temperature level higher than 38.6°C (AOR, 2.7; P = 0.016), and delayed cerebral ischemia (AOR, 3.6; P = 0.01). Among cognitively impaired patients at 3 months, improvement at 1 year occurred in 34{\%} and was associated with more than 12 years of education and the absence of fever higher than 38.6°C during hospitalization (P = 0.015). Patients with cognitive impairment at 1 year had worse concurrent QOL and less ability to perform instrumental and basic activities of daily living (all P < 0.001). CONCLUSION: Global cognitive impairment affects more than 20{\%} of subarachnoid hemorrhage survivors at 1 year, is predicted by fever, anemia treated with transfusion, and delayed cerebral ischemia, and adversely affects functional recovery and QOL.",
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