Outcomes Measures in Subarachnoid Hemorrhage Research.

Transl Stroke Res

Department of Neurology, University of Iowa, 200, Hawkins Drive, Iowa City, IA, USA.

Published: July 2024

AI Article Synopsis

  • Morbidity rates for subarachnoid hemorrhage (SAH) remain high despite improvements in treatment, making it essential to use standardized outcome scales in research to evaluate new therapies effectively.
  • This review discusses various clinical outcome scales and emphasizes the need to employ standardized terminology and diagnostic criteria to accurately report outcomes related to SAH.
  • Recommendations include using established severity scales in clinical trials, conducting neuropsychological evaluations to assess cognitive function, and integrating psychological and quality-of-life assessments to fully account for the impacts of SAH on patient well-being.

Article Abstract

Despite advancements in acute management, morbidity rates for subarachnoid hemorrhage (SAH) remain high. Therefore, it is imperative to utilize standardized outcome scales in SAH research for evaluating new therapies effectively. This review offers a comprehensive overview of prevalent scales and clinical outcomes used in SAH assessment, accompanied by recommendations for their application and prognostic accuracy. Standardized terminology and diagnostic criteria should be employed when reporting pathophysiological outcomes such as symptomatic vasospasm and delayed cerebral ischemia. Furthermore, integrating clinical severity scales like the World Federation of Neurosurgical Societies scale and modified Fisher score into clinical trials is advised to evaluate their prognostic significance, despite their limited correlation with outcomes. The modified Rankin score is widely used for assessing functional outcomes, while the Glasgow outcome scale-extended version is suitable for broader social and behavioral evaluations. Avoiding score dichotomization is crucial to retain valuable information. Cognitive and behavioral outcomes, though frequently affected in patients with favorable neurological outcomes, are often overlooked during follow-up outpatient visits, despite their significant impact on quality of life. Comprehensive neuropsychological evaluations conducted by trained professionals are recommended for characterizing cognitive function, with the Montreal Cognitive Assessment serving as a viable screening tool. Additionally, integrating psychological inventories like the Beck Depression and Anxiety Inventory, along with quality-of-life scales such as the Stroke-Specific Quality of Life Scale, can effectively assess behavioral and quality of life outcomes in SAH studies.

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Source
http://dx.doi.org/10.1007/s12975-024-01284-3DOI Listing

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