Reintegration to Normal Living, Life Satisfaction, Performance of Activities of Daily Living, and Quality of Life After Cerebrovascular Bypass Surgery for Brain Aneurysms
Research Associate USC Neurorestoration Center, Department of Neurological Surgery, Keck School of Medicine, University of Southern California
Introduction: Patient-reported outcomes are increasingly utilized as primary indicators of quality in neurosurgery. Little is known about the long-term outcomes for cerebral bypass surgery on various domains of health. We assessed the long-term reintegration to normal living, life satisfaction, performance of activities of daily living (ADLs), and quality of life (QoL) following cerebral bypass for brain aneurysms.
Methods: Individuals with brain aneurysms who had undergone bypass surgery between 2014-2020 were interviewed. The measures of interest included the Reintegration to Normal Living Index (RNLI), modified Barthel Index (mBI), Life Satisfaction Questionnaire (LiSat-9), and SF-36. Responses were analyzed to determine the quality of an individual's physical, emotional, and general aspects of life years after surgery. Baseline characteristics were compared between responders and non-responders to rule out selection bias.
Results: 58 patients were contacted of whom 30 (51.7%, 20 women, age=49.3±16.3 years) completed the questionnaires within an average follow-up of 4.9±1.5 years. 56.6% presented with ruptured aneurysms. The baseline characteristics were comparable between responders and non-responders. 83% of participants achieved the highest level of independence in ADLs (mBI=96.5%±5.44%). In terms of life satisfaction, the mean LiSat-9 score was 83.5±13.78, with sexual life being the main area of deficit. All domains of RNLI yielded high degrees of reintegration to normal living (total score=86.97%±12.8%), except for the ability to travel (mean=75.6%±22.1%). SF-36 subscales of physical role, emotional role/wellbeing, social function, and pain achieved an average score of >83% (range: 83-87%).
Conclusion : The majority of patients who had undergone cerebral bypass surgery for aneurysms achieved high levels of physical functioning, emotional wellbeing, general health, and reintegration into activities of daily living. Areas of deficit were highlighted, which can inform the development of multimodal rehabilitation programs. These findings should be compared to the normative data to better understand the lived experience and unique characteristics of patients with aneurysms.