Return to work and driving are major rehabilitation goals for patients after an aneurysmal subarachnoid hemorrhage (aSAH). Our goal is to identify factors that may predict return to work or driving after aSAH.
Medical records of patients with aSAH were retrospectively reviewed from 2010-2018. Information on return to work and driving were prospectively collected. Univariate analyses were performed to assess the association between return to work or driving with patient characteristics, social factors, and admission clinical and radiographic severity. Multivariate regression models were used to evaluate return to work and driving and generate predictive models.
193 patients were included, of which 32% (62/193) resumed work and 57% (110/193) returned to driving. Median follow-up time was 3.4 years [IQR=0.7-7.5 years]. Return to work was associated with younger age (OR0.89 [95%CI 0.85-0.94]) and lower Hunt and Hess grade (OR0.34 [95%CI 0.23-0.54]), and lack of seizures (OR0.09 [95%CI 0.02-0.47]. Return to driving was associated with younger age (OR0.94 [95%CI 0.91-0.98]), lower Hunt and Hess grade (OR0.36 [95%CI 0.23-0.56]), married status (OR3.4 [95%CI 1.2-9.4]), current or former smoking (OR3.9 [95%CI 1.5-10.1]), lack of recreational drug use (OR0.08 [95%CI 0.01-0.77]), and lack of seizures (OR0.28 [95%CI 0.08-0.96]). Admission risk factors were predictive of return to driving and return to work in the final multivariate models generated (area under the ROC curve 88% vs 89%, respectively).
As work may be highly dependent on complex individual and social factors, driving is a simple and more accurate assessment for an individual’s status after aSAH.
Copyright © 2020. Published by Elsevier Inc.