Effect of intraoperative events on quality of life in patients following clipping of ruptured anterior circulation aneurysms

Background: A significant subset of patients undergoing clipping for ruptured aneurysmal Subarachnoid Hemorrhage (SAH) continues to have impaired physical and psychological functions impacting the quality of life (QOL). The determinants of QOL are multifactorial. Surgical events such as intraoperative rupture and temporary clipping time are known to affect the Glasgow outcome score. However, the impact of these events on QOL has not been described to date. The aim of the study is to assess the effect of intraoperative events on QOL in the patient with ruptured anterior circulation aneurysms (ACA) clipping. Methods: A total of 94 patients were recruited into two groups of patients without or with any intraoperative events. QOL was assessed using stroke-specific QOL (SSQOL) and World Health Organization (WHO) QOL-brief assessment instrument (BREF) after 1 year of an event. Intraoperative events were defined as (1) intraoperative rupture during dissection, (2) temporary clipping time of more than 3 min. Results: Both groups were comparable on sociodemographic variables. After 1 year of SAH, both groups were identical on both measures of QOL. However, 48.9% of patients in Group B had poor QOL compared to 38.8% of patients in Group A on SSQOL. The most affected domain was energy. On WHOQOL-BREF, only 13.3% of patients in Group B and 10.2% in Group A had poor QOL. The difference in QOL outcome assessed by two scales was attributed to the difference in the nature of the scales. Conclusion: Although QOL was affected following a-SAH, intraoperative events were not found to be contributing toward the difference in QOL at 1 year.