The Factors Of Quality Of Life For Patients With Unruptured Intracranial Aneurysms After Operation: An Observational Study

Objectives:Through investigating the general demographic and pathological data of patients with Unruptured Intracranial Aneurysm,understanding the quality of life,anxiety and depression,and cognitive impairment after surgery.To analyze the main influencing factors of the quality of life of patients,and to explore the relationship among the quality of life,anxiety,depression and cognitive impairment,so as to provide theoretical basis for effective psychological intervention and treatment decision-making during perioperative period of patients with Unruptured Intracranial Aneurysms,and to provide scientific basis for improving the quality of life of patients with Unruptured Intracranial Aneurysms.Methods:A cross-sectional study was conducted.Choose the 127 patients with Unruptured Intracranial Aneurysms who were first diagnosed in neurosurgery department of a third-level general hospital in Nanchang as the subjects of study from June 2017 to December 2018.Self-designed general information questionnaire,European Five-Dimensional Health Scale(EQ-5D),Simple Mental State Scale(MMSE)and hospital anxiety and depression scale(HAD)were used for questionnaire survey.All the data collected were analyzed by SPSS 17.0 and Excel 2013,including descriptive analysis,t test,one-way ANOVA,single factor analysis,multiple linear regression analysis.Results:1.General demographic and disease data of patients: A total of 127 patients were included in this study,age range from 18 to 89.The average age was(56.94±10.66)years old,with 80 females(63%)and 47 males(37%).81 patients(63.77%)were treated with interventional embolization,clamping treatment in 46 cases(36.22%).There was no significant difference in age,sex and surgical method among thesubjects.2.The current situation of patients' quality of life,anxiety,depression and cognitive impairment: The total score of EQ-5D health index in patients with Unruptured Intracranial Aneurysms was(0.729 ± 0.243),the action dimension was(0.030 ± 0.056),the self-care dimension was(0.016 ± 0.048),the daily activity dimension was(0.024±0.048),the pain or discomfort dimension was(0.089±0.067),the anxiety or depression dimension was(0.071 ± 0.074),and the total score of cognitive impairment was(21.80 ± 6.50).Postoperative cognitive impairment was found in 44.09% of the patients and 55.91% of the patients without cognitive impairment.3.Univariate analysis of quality of life in patients with Unruptured Intracranial Aneurysms:(1)The results showed that the influence of gender,age,family income per capita and long-term residence in demographic data on postoperative quality of life scores of patients was statistically significant(P < 0.05),(2)There were statistically significant differences in the effect of surgical method,aneurysm size,smoking history,hypertension history,combined with other diseases and postoperative complications on postoperative quality of life of patients in the data of diseases(P <0.05),(3)The influence of anxiety and depression on postoperative quality of life was statistically significant(P<0.05),(4)Cognitive impairment had a statistically significant difference in patients' quality of life scores(P<0.05).4.Multiple linear regression analysis: The results showed that anxiety,history of hypertension,depression,postoperative complications,aneurysm size and surgical methods were the main factors affecting the quality of life of patients with Unruptured Intracranial Aneurysms.Conclusions:1.The postoperative quality of life of patients with unruptured intracranial aneurysm was at the medium level,among which the scores of action dimension,self-care dimension and daily activity dimension were lower.2.Patients with unruptured intracranial aneurysm have different levels of anxiety,depression and cognitive impairment after surgery,43.31% of the patients had anxiety,35.12% had depression,and 44.09% had cognitive impairment.Anxiety,depression and cognitive impairment are closely related to postoperative quality of life and are important influencing factors of quality of life.Medical staff should pay close attention to postoperative patients with cognitive impairment and prone to anxiety and depression,develop personalized nursing measures to improve the quality of life of patients,establish a sense of trust,give patients positive psychological hints,and increase patients' confidence.3.Anxiety,history of hypertension,depression,postoperative complications,and aneurysm size and operation mode are the main factors affecting postoperative quality of life of patients with Unruptured Intracranial Aneurysm.It is suggested that medical staff should guide patients to take comprehensive consideration before operation,carefully select treatment methods,closely monitor blood pressure and other vital signs after operation,strive to meet patients' needs to the greatest extent,and take active intervention measures to promote patients' recovery.