Survival, dependency, and health-related quality of life in patients with ruptured intracranial aneurysm: 10-year follow-up of the united kingdom cohort of the international subarachnoid aneurysm trial
<p><strong>Background:</strong><br /> Previous analyses of the International Subarachnoid Aneurysm Trial (ISAT) cohort have reported on clinical outcomes after treatment of a ruptured intracranial aneurysm with either neurosurgical clipping or endovascular coiling.</p>&...
| Main Authors: | , , , , , , , , |
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| פורמט: | Journal article |
| שפה: | English |
| יצא לאור: |
Oxford University Press
2020
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| _version_ | 1826308617022734336 |
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| author | Hua, X Gray, A Wolstenholme, J Clarke, P Molyneux, AJ Kerr, R Clarke, A Sneade, M Rivero Arias, O |
| author_facet | Hua, X Gray, A Wolstenholme, J Clarke, P Molyneux, AJ Kerr, R Clarke, A Sneade, M Rivero Arias, O |
| author_sort | Hua, X |
| collection | OXFORD |
| description | <p><strong>Background:</strong><br />
Previous analyses of the International Subarachnoid Aneurysm Trial (ISAT) cohort have reported on clinical outcomes after treatment of a ruptured intracranial aneurysm with either neurosurgical clipping or endovascular coiling.</p><br />
<p><strong>Objective:</strong><br />
To evaluate the long-term quality-adjusted life years (QALYs) gained of endovascular coiling compare to neurosurgical clipping in the UK cohort of ISAT.</p><br />
<p><strong>Methods:</strong><br />
Between September 12, 1994 and May 1, 2002, patients with ruptured intracranial aneurysms who were assumed treatment equipoise were randomly allocated to either neurosurgical clipping or endovascular coiling. We followed-up 1644 patients in 22 UK neurosurgical centers for a minimum of 10 yr. Health-related quality of life (HRQoL) was collected through yearly questionnaires, measured by utilities calculated from the EQ-5D-3L. We compared HRQoL between the 2 treatment groups over a period of 10 yr. In all, 1-yr, 5-yr, and 10-yr QALYs were estimated by combining utility and survival information.</p><br />
<p><strong>Results:</strong><br />
Higher average utility values were found in the endovascular group throughout the follow-up period, with mean differences between groups statistically significant in most years. The 10-yr QALYs were estimated to be 6.68 (95% CI: 6.45-6.90) in the coiling group and 6.32 (95% CI: 6.10-6.55) in the clipping group, respectively, a significant mean difference of 0.36 (95% CI: 0.04-0.66). A third of this mean QALYs gain was estimated to derive solely from HRQoL differences.</p><br />
<p><strong>Conclusion:</strong><br />
HRQoL after treatment of a ruptured intracranial aneurysm was better after endovascular coiling compared to neurosurgical clipping, which contributed significantly to the QALYs gained over a 10-yr period.</p> |
| first_indexed | 2024-03-07T07:21:58Z |
| format | Journal article |
| id | oxford-uuid:e2e4f42c-c6cf-4e12-93cb-2bf7399c65b3 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:21:58Z |
| publishDate | 2020 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:e2e4f42c-c6cf-4e12-93cb-2bf7399c65b32022-10-17T08:55:27ZSurvival, dependency, and health-related quality of life in patients with ruptured intracranial aneurysm: 10-year follow-up of the united kingdom cohort of the international subarachnoid aneurysm trialJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e2e4f42c-c6cf-4e12-93cb-2bf7399c65b3EnglishSymplectic ElementsOxford University Press2020Hua, XGray, AWolstenholme, JClarke, PMolyneux, AJKerr, RClarke, ASneade, MRivero Arias, O<p><strong>Background:</strong><br /> Previous analyses of the International Subarachnoid Aneurysm Trial (ISAT) cohort have reported on clinical outcomes after treatment of a ruptured intracranial aneurysm with either neurosurgical clipping or endovascular coiling.</p><br /> <p><strong>Objective:</strong><br /> To evaluate the long-term quality-adjusted life years (QALYs) gained of endovascular coiling compare to neurosurgical clipping in the UK cohort of ISAT.</p><br /> <p><strong>Methods:</strong><br /> Between September 12, 1994 and May 1, 2002, patients with ruptured intracranial aneurysms who were assumed treatment equipoise were randomly allocated to either neurosurgical clipping or endovascular coiling. We followed-up 1644 patients in 22 UK neurosurgical centers for a minimum of 10 yr. Health-related quality of life (HRQoL) was collected through yearly questionnaires, measured by utilities calculated from the EQ-5D-3L. We compared HRQoL between the 2 treatment groups over a period of 10 yr. In all, 1-yr, 5-yr, and 10-yr QALYs were estimated by combining utility and survival information.</p><br /> <p><strong>Results:</strong><br /> Higher average utility values were found in the endovascular group throughout the follow-up period, with mean differences between groups statistically significant in most years. The 10-yr QALYs were estimated to be 6.68 (95% CI: 6.45-6.90) in the coiling group and 6.32 (95% CI: 6.10-6.55) in the clipping group, respectively, a significant mean difference of 0.36 (95% CI: 0.04-0.66). A third of this mean QALYs gain was estimated to derive solely from HRQoL differences.</p><br /> <p><strong>Conclusion:</strong><br /> HRQoL after treatment of a ruptured intracranial aneurysm was better after endovascular coiling compared to neurosurgical clipping, which contributed significantly to the QALYs gained over a 10-yr period.</p> |
| spellingShingle | Hua, X Gray, A Wolstenholme, J Clarke, P Molyneux, AJ Kerr, R Clarke, A Sneade, M Rivero Arias, O Survival, dependency, and health-related quality of life in patients with ruptured intracranial aneurysm: 10-year follow-up of the united kingdom cohort of the international subarachnoid aneurysm trial |
| title | Survival, dependency, and health-related quality of life in patients with ruptured intracranial aneurysm: 10-year follow-up of the united kingdom cohort of the international subarachnoid aneurysm trial |
| title_full | Survival, dependency, and health-related quality of life in patients with ruptured intracranial aneurysm: 10-year follow-up of the united kingdom cohort of the international subarachnoid aneurysm trial |
| title_fullStr | Survival, dependency, and health-related quality of life in patients with ruptured intracranial aneurysm: 10-year follow-up of the united kingdom cohort of the international subarachnoid aneurysm trial |
| title_full_unstemmed | Survival, dependency, and health-related quality of life in patients with ruptured intracranial aneurysm: 10-year follow-up of the united kingdom cohort of the international subarachnoid aneurysm trial |
| title_short | Survival, dependency, and health-related quality of life in patients with ruptured intracranial aneurysm: 10-year follow-up of the united kingdom cohort of the international subarachnoid aneurysm trial |
| title_sort | survival dependency and health related quality of life in patients with ruptured intracranial aneurysm 10 year follow up of the united kingdom cohort of the international subarachnoid aneurysm trial |
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