한빛사
>
한빛사논문
한빛사논문
- 조회154
이호석Ho Seok Lee
성균관대학교 의과대학, 삼성서울병원
JAMA Netw. Open, Mar 03 2025, 8 (3) | https://doi.org/10.1001/jamanetworkopen.2025.1678
Five-Year Functional Outcomes Among Patients Surviving Aneurysmal Subarachnoid Hemorrhage
Ho Seok Lee, MD, PhD1; Min Kyun Sohn, MD, PhD2; Jongmin Lee, MD, PhD3; Deog Young Kim, MD, PhD4; Yong-Il Shin, MD, PhD5; Gyung-Jae Oh, MD, PhD6; Yang-Soo Lee, MD, PhD7; Min Cheol Joo, MD, PhD8; So Young Lee, MD, PhD9; Min-Keun Song, MD, PhD10; Junhee Han, PhD11; Jeonghoon Ahn, PhD12; Young-Hoon Lee, MD, PhD6; Dae Hyun Kim, MD, PhD1; Young-Taek Kim, PhD13; Yun-Hee Kim, MD, PhD14,15; Won Hyuk Chang, MD, PhD1,16,17
1Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
2Department of Rehabilitation Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
3Department of Rehabilitation Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea
4Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
5Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
6Department of Preventive Medicine, Wonkwang University, School of Medicine, Iksan, Republic of Korea
7Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
8Department of Rehabilitation Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea
9Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju City, Republic of Korea
10Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
11Department of Statistics, Hallym University, Chuncheon, Republic of Korea
12Department of Health Convergence, Ewha Womans University, Seoul, Republic of Korea
13Department of Preventive Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
14Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
15Myongji Choonhye Rehabilitation Hospital, Seoul, Republic of Korea
16Department of Health Science and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
17Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
Corresponding Authors: Won Hyuk Chang, MD, PhD, Yun-Hee Kim, MD, PhD
1Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
2Department of Rehabilitation Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
3Department of Rehabilitation Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea
4Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
5Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
6Department of Preventive Medicine, Wonkwang University, School of Medicine, Iksan, Republic of Korea
7Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
8Department of Rehabilitation Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea
9Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju City, Republic of Korea
10Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
11Department of Statistics, Hallym University, Chuncheon, Republic of Korea
12Department of Health Convergence, Ewha Womans University, Seoul, Republic of Korea
13Department of Preventive Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
14Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
15Myongji Choonhye Rehabilitation Hospital, Seoul, Republic of Korea
16Department of Health Science and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
17Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
Corresponding Authors: Won Hyuk Chang, MD, PhD, Yun-Hee Kim, MD, PhD
Abstract
Importance Longitudinal changes in functional levels can provide valuable information about disability. However, longitudinal outcomes in aneurysmal subarachnoid hemorrhage (aSAH) have not been well reported, which could provide insight into appropriate management and information for patients experiencing disability.
Objective To investigate the 5-year prognosis and functional outcomes of patients with aSAH.
Design, Setting, and Participants This retrospective cohort study used data of patients with aSAH from the Korean Stroke Cohort for Functioning and Rehabilitation study up to 5 years after onset. Data were collected from August 2012 through May 2015 in 9 different hospitals in Korea. Data were analyzed from September 2023 through January 2024.
Exposure Patients with aSAH surviving at least 7 days after onset.
Main Outcomes and Measures Assessments were performed serially from 7 days to 5 years after onset. Prognosis, measured by the modified Rankin scale (mRS) in terms of positive outcome (mRS score of 0 or 1), and mortality were analyzed. In addition, sequential functional outcomes were assessed using the Functional Independence Measure (FIM) in survivors of aSAH at 5 years after onset. Multiple imputation method was used to handle missing data. Wilcoxon signed-rank test and paired t test were used to analyze differences in functional measurements between each follow-up period. Additionally, a generalized mixed-effects model was used to analyze the longitudinal trajectory of the FIM.
Results A total of 338 patients with aSAH (mean [SD] age, 56.3 [13.0] years; 207 female [61.2%]) were included. Among survivors of aSAH at 7 days, the 5-year mortality rate was 8.3% (28 participants). The distribution of mRS significantly improved until 4 years and then plateaued, with 180 (53.3%) and 77 (22.8%) patients reporting an mRS score of 0 and 1, respectively. FIM showed a significant improvement up to 4 years (mean [SD] score, 118.9 [18.7]) and then plateaued.
Conclusions and Relevance In this cohort study, the functional outcomes in patients with aSAH continued to improve up to 4 years after onset, with the majority of participants showing favorable outcomes without significant disability, suggesting that proper long-term assessment is needed and appropriate management should be emphasized to maximize potential outcomes of patients with aSAH.
Objective To investigate the 5-year prognosis and functional outcomes of patients with aSAH.
Design, Setting, and Participants This retrospective cohort study used data of patients with aSAH from the Korean Stroke Cohort for Functioning and Rehabilitation study up to 5 years after onset. Data were collected from August 2012 through May 2015 in 9 different hospitals in Korea. Data were analyzed from September 2023 through January 2024.
Exposure Patients with aSAH surviving at least 7 days after onset.
Main Outcomes and Measures Assessments were performed serially from 7 days to 5 years after onset. Prognosis, measured by the modified Rankin scale (mRS) in terms of positive outcome (mRS score of 0 or 1), and mortality were analyzed. In addition, sequential functional outcomes were assessed using the Functional Independence Measure (FIM) in survivors of aSAH at 5 years after onset. Multiple imputation method was used to handle missing data. Wilcoxon signed-rank test and paired t test were used to analyze differences in functional measurements between each follow-up period. Additionally, a generalized mixed-effects model was used to analyze the longitudinal trajectory of the FIM.
Results A total of 338 patients with aSAH (mean [SD] age, 56.3 [13.0] years; 207 female [61.2%]) were included. Among survivors of aSAH at 7 days, the 5-year mortality rate was 8.3% (28 participants). The distribution of mRS significantly improved until 4 years and then plateaued, with 180 (53.3%) and 77 (22.8%) patients reporting an mRS score of 0 and 1, respectively. FIM showed a significant improvement up to 4 years (mean [SD] score, 118.9 [18.7]) and then plateaued.
Conclusions and Relevance In this cohort study, the functional outcomes in patients with aSAH continued to improve up to 4 years after onset, with the majority of participants showing favorable outcomes without significant disability, suggesting that proper long-term assessment is needed and appropriate management should be emphasized to maximize potential outcomes of patients with aSAH.
논문정보
- Research article
- 2025년 03월 (BRIC 등록일 2025-03-30)
- 국내 연구진
- 의약학 > 신경의학
댓글 작성 로그인
팝업 닫기관련 링크
연구자 키워드
연구자 ID
관련분야 연구자보기
소속기관 논문보기
관련분야 논문보기
