A Partial Least-Squares Analysis of Health-Related Quality-of-Life Outcomes After Aneurysmal Subarachnoid Hemorrhage.

Abstract

BACKGROUND:

Individuals who have aneurysmal subarachnoid hemorrhages (SAHs) experience decreased health-related qualities of life (HRQoLs) that persist after the primary insult.

OBJECTIVE:

To identify clinical variables that concurrently associate with HRQoL outcomes by using a partial least-squares approach, which has the distinct advantage of explaining multidimensional variance where predictor variables may be highly collinear.

METHODS:

Data collected from the CONSCIOUS-1 trial was used to extract 29 clinical variables including SAH presentation, hospital procedures, and demographic information in addition to 5 HRQoL outcome variables for 256 individuals. A partial least-squares analysis was performed by calculating a heterogeneous correlation matrix and applying singular value decomposition to determine components that best represent the correlations between the 2 sets of variables. Bootstrapping was used to estimate statistical significance.

RESULTS:

The first 2 components accounting for 81.6% and 7.8% of the total variance revealed significant associations between clinical predictors and HRQoL outcomes. The first component identified associations between disability in self-care with longer durations of critical care stay, invasive intracranial monitoring, ventricular drain time, poorer clinical grade on presentation, greater amounts of cerebral spinal fluid drainage, and a history of hypertension. The second component identified associations between disability due to pain and discomfort as well as anxiety and depression with greater body mass index, abnormal heart rate, longer durations of deep sedation and critical care, and higher World Federation of Neurosurgical Societies and Hijdra scores.

CONCLUSION:

By applying a data-driven, multivariate approach, we identified robust associations between SAH clinical presentations and HRQoL outcomes.

ABBREVIATIONS:

EQ-VAS, EuroQoL visual analog scaleHRQoL, health-related quality of lifeICU, intensive care unitIVH, intraventricular hemorrhagePLS, partial least squaresSAH, subarachnoid hemorrhageSVD, singular value decompositionWFNS, World Federation of Neurosurgical Societies.

• Authors: Julia M Young, Benjamin R Morgan, Bratislav Mišić, Tom A Schweizer, George M Ibrahim, R Loch Macdonald
• Journal: Neurosurgery (Neurosurgery) Vol. 77 Issue 6 Pg. 908-15; discussion 915 (Dec 2015) ISSN: 1524-4040 [Electronic] United States
• PMID: 26248048 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Dioxanes
• Pyridines
• Pyrimidines
• Sulfonamides
• Tetrazoles
• clazosentan

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anxiety (etiology)
• Depression (etiology)
• Dioxanes (therapeutic use)
• Female
• Health Status
• Humans
• Intracranial Aneurysm (complications, psychology, therapy)
• Least-Squares Analysis
• Male
• Middle Aged
• Outcome Assessment, Health Care
• Pain (etiology)
• Pyridines (therapeutic use)
• Pyrimidines (therapeutic use)
• Quality of Life
• Self Care
• Subarachnoid Hemorrhage (complications, psychology, therapy)
• Sulfonamides (therapeutic use)
• Tetrazoles (therapeutic use)
• Young Adult