Advances in Clinical and Experimental Medicine
2017, vol. 26, nr 6, September, p. 981–986
Publication type: original article
Application of the functional capacity scale in the early assessment of functional efficiency in patients after aneurysm embolization: Preliminary reports
1 Neurological and Neurosurgical Nursing Department, Faculty of Health Sciences, Collegium Medicum, Nicolaus Copernicus University, Toruń, Poland
2 Clinic of Geriatrics, Faculty of Health Sciences, Collegium Medicum, Nicolaus Copernicus University, Toruń, Poland
3 Neurotraumatology Department, Faculty of Health Sciences, Collegium Medicum, Nicolaus Copernicus University, Toruń, Poland
4 Department of Surgical Nursing, Chair of Perioperative Nursing, Faculty of Health Sciences, Collegium Medicum, Nicolaus Copernicus University, Toruń, Poland
5 Department of Nervous System Diseases, Faculty of Health Science, Wroclaw Medical University, Poland
Background. While data on the long-term (e.g., 1 year and subsequent years) outcomes of intracranial aneurysms treatment is relatively well-documented mainly in the clinical aspect (comparability of treatment, mortality, and complications), little is known about the early results, in terms of the functional outcome.
Objectives. The aim of the study was to analyze the use of Functional Capacity Scale (FCS) in the evaluation of patients in the early period after endovascular treatment of intracranial aneurysms.
Material and Methods. The study was conducted in the Neurosurgery Clinic, University Hospital Collegium Medicum in Bydgoszcz, on a group of 118 consecutively admitted patients with the diagnosis of intracranial aneurysm, qualified for treatment using the endovascular method (embolization). The assessment was performed twice. In the clinical assessment the Glasgow Coma Scale (GCS) was used to evaluate the level of consciousness and the Hunt and Hess Scale (H&H) to assess the patient’s condition. To assess the final outcome and early functional capacity Glasgow Outcome Scale (GOS), Barthel Index (BI), Modified Rankin Scale (mRS) and the new Functional Capacity Scale were used.
Results. The assessment performed with the FCS was comparable to the assessment conducted with standardized tools such as BI, mRS or GOS. The clinical condition assessed with the GCS (p < 0.001) and H&H (p < 0.001) differentiates the functional condition assessed using the FCS. Statistically significant correlations were found between FCS and BI (r = -0.78), GOS (r = -0.69) and mRS (r = 0.68).
Conclusion. The study indicates that the FCS correlates with other scales used in the assessment of patients with intracranial aneurysm, which means that the proposed tool can be applied successfully in practice. However, further randomized multicenter studies are necessary in order to clarify the final conclusion.
functional assessment, outcome, aneurysm, subarachnoid hemorrhage
- Rinkel GJ, Algra A. Long-term outcomes of patients with aneurysmal subarachnoid haemorrhage. Lancet Neurol. 2011;10:349–356.
- Lanzino G, Crobeddu E. Can we predict rebleeding after aneurysmal subarachnoid hemorrhage (SAH)? World Neurosurg. 2011;76:253–254.
- Bor AS, Rinkel GJ, van Norden J, Wermer MJH. Long-term, serial screening for intracranial aneurysms in individuals with a family history of aneurysmal subarachnoid haemorrhage: A cohort study. Lancet Neurol. 2014;13:385–392.
- Pyysalo LM, Niskakangas TT, Keski-Nisula LH, Kähärä VJ, Öhman JE. Long-term outcome after subarachnoid haemorrhage of unknown etiology. J Neurol Neurosurg Psychiatry. 2011;82:1264–1266.
- Wermer MJH, Greebe P, Algra A, Rinke GJE. Long-term mortality and vascular event risk after aneurysmal subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry. 2009;80:1399–1401.
- Molyneux AJ, Kerr R, Stratton I, et al. International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: A randomised trial. Lancet. 2002;360:1267–1274.
- Molyneux AJ, Kerr R, Yu LM, et al. International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group. International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: A randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet. 2005;366:809–817.
- Molyneux AJ, Kerr RS, Birks J, et al. ISAT Collaborators. Risk of recurrent subarachnoid haemorrhage, death, or dependence and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the International Subarachnoid Aneurysm Trial (ISAT): Long-term follow-up. Lancet Neurol. 2009;8:427–433.
- McDougall CG, Spetzler RF, Zabramski JM, et al. Albuquerque FC. The Barrow Ruptured Aneurysm Trial. J Neurosurg. 2012;116:135–144.
- Teasdale G, Jennett B. Assessment of coma and impaired consciousness: A practical scale. Lancet. 1974;2:81–83.
- Hunt WE, Hess RM. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg. 1968;28:14–20.
- Report of World Federation of Neurological Surgeons Committee on a Universal Subarachnoid Hemorrhage Grading Scale. J Neurosurg. 1988;68:985–986.
- Mahoney FI, Barthel DW. Functional evaluation: The Barthel Index. Md State Med J. 1965;14:56–61.
- van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J. Interobserver agreement for the assessment of handicap in stroke patients. Stroke. 1988;19:604–607.
- Jennett B, Bond M. Assessment of outcome after severe brain damage: A practical scale. Lancet. 1975;1:480–484.
- Ślusarz R, Biercewicz M, Rybicka R, Beuth W, Śniegocki M. Functional capacity of patients in the early period after the embolization of cerebrovascular malformations: Preliminary findings. J Neurosci Nurs. 2012;44:253–259.
- Ślusarz R, Biercewicz M, Rybicka R. Functional capacity scale in assessment of patients with intracranial aneurysms: Reliability and validity. J Neurosci Nurs. 2014;46:46–54.
- Al-Khindi T, Macdonald RL, Schweizer TA. Cognitive and functional outcome after aneurysmal subarachnoid hemorrhage. Stroke. 2010;41:e519–536.
- Shirao S, Yoneda H, Kunitsugu I, et al. Preoperative prediction of outcome in 283 poor-grade patients with subarachnoid hemorrhage: A project of the Chugoku-Shikoku Division of the Japan Neurosurgical Society. Cerebrovasc Dis. 2010;30:105–113.
- Salary M, Quigley MR, Wilberger JE Jr. Relation among aneurysm size, amount of subarachnoid blood, and clinical outcome. J Neurosurg. 2007;107:13–17.
- Taki W, Sakai N, Suzuki H. Determinants of poor outcome after aneurysmal subarachnoid hemorrhage when both clipping and coiling are available: Prospective Registry of Subarachnoid Aneurysms Treatment (PRESAT) in Japan. World Neurosurg. 2011;76:437–445.
- Haug T, Sorteberg A, Finset A, Lindegaard KF, Lundar T, Sorteberg W. Cognitive functioning and health-related quality of life 1 year after aneurysmal subarachnoid hemorrhage in preoperative comatose patients (Hunt and Hess grade V patients). Neurosurgery. 2010;66:475–484.
- van Heuven AW, Dorhout Mees SM, Algra A, Rinkel GJ. Validation of a prognostic subarachnoid hemorrhage grading scale derived directly from the Glasgow Coma Scale. Stroke. 2008;39:1347–1348.
- Degen LA, Dorhout Mees SM, Algra A, Rinkel GJ. Interobserver variability of grading scales for aneurysmal subarachnoid hemorrhage. Stroke. 2011;42:1546–1549.
- Koivisto T, Vanninen R, Hurskainen H, Saari T, Hernesniemi J, Vapalahti M. Outcomes of early endovascular versus surgical treatment of ruptured cerebral aneurysms: A prospective randomized study. Stroke. 2000;10:2369–2377.
- Kim DH, Haney CL, Van Ginhoven G. Utility of outcome measures after treatment for intracranial aneurysms: A prospective trial involving 520 patients. Stroke. 2005;36:792–796.
- Kirkness CJ, Thompson JM, Ricker BA, et al. The impact of aneurysmal subarachnoid hemorrhage on functional outcome. J Neurosci Nurs. 2002;34:134–141.