Trajectory of Functional Recovery After Hospital Discharge for Subarachnoid Hemorrhage

Background: Although there are extensive data on long-term disability after subarachnoid hemorrhage (SAH), there are few data on the trajectory of functional recovery after hospital discharge.

Methods: From October 2009 to April 2010, we prospectively followed consecutive patients with non-traumatic SAH discharged from a university hospital. Modified Rankin Scale (mRS) scores were calculated at discharge from chart review and at 6 months by standardized telephone interview. Good functional status was defined as a mRS score of 0-2, and poor status as an mRS score of 3-6. Descriptive statistics were used to assess the trajectory of functional recovery and determine the proportion of patients whose functional status improved from poor to good.

Results: Among 52 patients with non-traumatic SAH (79 % aneurysmal) who were discharged alive, most (71 %) were discharged home. Median (IQR) mRS score was 3 (2-4) at discharge and 2 (1-2) at 6 months. Some functional recovery (any improvement in mRS score) was seen in most patients (83 %; 95 % CI, 72-93 %). Of the 28 patients with poor functional status at discharge, 16 (57 %) improved to good functional status at 6 months. All patients with Hunt-Hess grade 4 or 5 hemorrhages (n = 14) had poor functional status at discharge, but half (95 % CI, 20-80 %) recovered to a good functional status at 6 months.

Conclusions: Although our sample size is small, our findings suggest that a substantial proportion of patients with SAH who are disabled at discharge go on to regain functional independence within 6 months.