Comparison of cohorts of elective and emergency neurosurgical patients: psychosocial outcomes of acoustic neuroma and aneurysmal sub arachnoid hemorrhage patients and carers.

摘要

OBJECTIVES: To compare the psychosocial outcomes of cohorts of elective [Acoustic Neuroma (AN)] and emergency [Aneu-rysmal Sub Arachnoid Hemorrhage (ASAH)] Neurosurgical patients and carers. METHODS: The standardized Wessex Patient Carer Questionnaire was designed with patients and carers and provided psychosocial and economic outcome data following elective or emergency surgery. Clinical data on size of tumor and size of bleed, respectively, were extracted from Consultant notes. RESULTS: Both cohorts were generally satisfied with neurosurgical in-patient care but both suffered high-economic costs and were predominately very dissatisfied with community care. There were significant psychosocial differences between elective and emergency patients, and despite greater relative physical disability among elective patients, it was the emergency cohort who had worse psychosocial outcomes. CONCLUSIONS: Despite many common psychosocial features, the differences between the cohorts were mainly psychological rather than physiological, because of greater 'post-traumatic-stress-reaction' in the emergency cohort, indicating the need for appropriate psychosocial care immediately after neurosurgery to reduce unnecessary distress and costs to patients, carers, and community.