Long-Term Outcome of Patients Discharged to a Nursing Home After Aneurysmal Subarachnoid Hemorrhage

Greebe P, Rinkel GJ, Algra A. Long-tern) outcome of patients discharged to a nursing home after aneurysmal subarachnoid hemorrhage. Arch Phys Med Rehabil 2010;91:247-51. Objective: To study long-term outcome in patients with aneurysmal subarachnoid hemorrhage (SAH) who are relatively young. Design: Retrospective cohort study. Setting: Nursing homes. Participants: Patients with SAH (N=92) admitted to our hospital from 1996 to 2006 who were discharged to a nursing home. Interventions: Not applicable. Main Outcome Measures: Death, discharge from nursing home, and functional status at end of follow-up. Results: Of the 92 patients included, 45 had died after a median of 1.1 years (range, 0.0-8.5y), 35 were discharged to home or a sheltered housing or rehabilitation center after a median of 0.6 years (range, 0.1-9.6y), and 12 remained in a nursing home after a median of 4.8 years (range, 2.2-12.0y). Forty-four (43%) had survived longer than 5 years, and 29 (31%) had regained functional independence within the initial 2 years after admission to the nursing home. Early discharge tended to occur more often in patients admitted from 2001 to 2006 than in those admitted from 1996 to 2001 (hazard ratio=1.8; 95% confidence interval, 0.9-3.7) and in those with an aneurysm not in the anterior communicating artery (hazard ratio=1.9; 95% confidence interval, 0.9-3.9). Conclusions: The prognosis for patients with SAH after admission to a nursing home is not gloomy. The type of rehabilitation that offers best chances to these patients needs to be investigated.