■动脉瘤性蛛网膜下腔出血(aSAH)的幸存者通常在没有严重身体或认知缺陷的情况下康复。然而,据报道,在结局良好或优异的aSAH患者中,参与生产性就业的水平也非常低.关于aSAH后重返工作岗位(RTW)的知识和没有RTW的预测因素仍然有限且存在争议。该研究旨在描述整个aSAH严重程度谱中更多连续aSAH患者在发病后长达5年的最大工作能力恢复情况,并确定没有RTW的人口统计学和医学预测因素。
■数据来自前瞻性机构数据库。我们纳入了2012年1月至2018年3月期间接受治疗的所有500名年龄>18岁的aSAH幸存者。除了收集有关ictus的工作状态和工作类型的数据外,我们检索了人口统计学数据,并根据蛛网膜下腔的量化评估了aSAH的严重程度,心室内,和实质内血液(ICH),以及世界神经学会联合会(WFNS)等级。我们记录了动脉瘤修复的模式(血管内或手术),并记录了血管痉挛等并发症,新获得的脑梗塞,和慢性脑积水.
■此外,记录随访时的工作状态和疲劳程度.对299名在ictus工作的患者进行了RTW评估。其中,63.2%是女性,年龄为51.3±9.4(20-71)岁。就业回报率为51.2%,完整的RTW占32.4%。无RTW的独立预测因素是年龄,WFNS3级,积极吸烟。最强的独立预测因子是临床上显著的疲劳,这将不返回工作岗位的风险增加了5倍。随着个人在出血前的受教育年限的增加,恢复有酬就业的机会显著增加。动脉瘤修复的模式与RTW无关。与WFNS3-5级患者相比,WFNS1-2级患者恢复工作的频率更高,但是我们的结果表明,与aSAH严重程度相比,神经运动缺陷与没有RTW的联系更紧密。
■疲劳需要作为返回工作整合路径上的重要元素来解决。
UNASSIGNED: Survivors of aneurysmal subarachnoid hemorrhage (aSAH) often recover without severe physical or cognitive deficits. However, strikingly low levels of engagement in productive employment have also been reported in aSAH patients with good or excellent outcomes. Knowledge about return to work (RTW) after aSAH and predictors of no RTW remain limited and controversial. The study aimed to delineate the return to maximum work capacity up to 5 years after the ictus in a larger number of consecutive aSAH patients from the entire aSAH severity spectrum and to identify demographic and medical predictors of no RTW.
UNASSIGNED: Data were acquired from a prospective institutional database. We included all 500 aSAH survivors aged > 18 years who were treated between January 2012 and March 2018. In addition to gathering data on work status and the type of work at ictus, we retrieved demographical data and assessed aSAH severity based on the quantification of subarachnoid, intraventricular, and intraparenchymal blood (ICH), as well as the World Federation of Neurological Societies (WFNS) grade. We registered the mode of aneurysm repair (endovascular or surgical) and recorded complications such as vasospasm, newly acquired cerebral infarctions, and chronic hydrocephalus.
UNASSIGNED: Furthermore, work status and the grade of fatigue at follow-up were registered. RTW was assessed among 299 patients who were employed at ictus. Among them, 63.2% were women, and their age was 51.3 ± 9.4 (20-71) years. Return to gainful employment was 51.2%, with complete RTW accounting for 32.4%. The independent predictors of no RTW at ictus were age, the WFNS grade 3, and active smoking. The strongest independent predictor was the presence of clinically significant fatigue, which increased the risk of not returning to work by 5-fold. The chance to return to gainful employment significantly increased with the individual\'s years of education prior to their hemorrhage. The mode of aneurysm repair was not relevant with regard to RTW. Patients in the WFNS grades 1-2 more often returned to work than those in the WFNS grades 3-5, but our results indicate that neurological motor deficits are linked closer to no RTW than aSAH severity per se.
UNASSIGNED: Fatigue needs to be addressed as an important element on the path to return to work integration.