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Predicting return to work after subarachnoid hemorrhage using the Montreal Cognitive Assessment (MoCA)

  • Clinical Article - Vascular
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Abstract

Background

Returning to work is a major issue for patients having had an aneurysmal subarachnoid hemorrhage (SAH). It is important, at an early stage, to identify the patients that are unlikely to return to work. The objective of this study was to assess the predictive value of the Montreal Cognitive Assessment (MoCA) at 6 months after ictus on return to work at 12 months.

Methods

In this prospective study were 96 patients with SAH included in the acute phase. Cognitive functions were assessed at 6 months using the MoCA and return to work at 12 months. The predictive value of MoCA on return to work was analyzed using the area under the receiver operating characteristic curve as well as logistic regression.

Results

Of those that had work before the SAH, 52 % were working at 12 months after the ictus. These patients had scored significantly better on MoCA at 6 months (p = 0.01). The area under the receiver operating characteristic curve was 0.75. By using a cut-off on MoCA of <27, 68 % of the patients could be correctly classified as returned/not returned to work. Adding data from the acute phase to the MoCA in a logistic regression model increased the percentage of patients correctly classified as returned/not returned to work by 2 %.

Conclusions

Returning to work is a major issue for SAH patients. It is important to identify factors that may interfere with a patient’s ability to return to work, and address these issues appropriately. In our study, estimating cognitive functions at 6 months after SAH using the MoCA alone allowed us to predict return to work correctly in 68 % of the cases. We feel that this provides useful information in planning rehabilitation, but that other post-SAH symptoms have to be considered as well.

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Authors and Affiliations

  1. Department of Neuroscience, Section of Neurosurgery, Uppsala University, SE-751 85, Uppsala, Sweden

    Svante Wallmark & Elisabeth Ronne-Engström

  2. Department of Neuroscience, Section of Neurology, Uppsala University, Uppsala, Sweden

    Erik Lundström

Authors
  1. Svante Wallmark
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  2. Elisabeth Ronne-Engström
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  3. Erik Lundström
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Corresponding author

Correspondence to Svante Wallmark.

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Funding

Erik, Karin and Gösta Selanders Foundation, Hedström’s, Ländell’s and Larsson’s Foundation at Uppsala University provided financial support in the form of grant funding. The sponsors had no role in the design or conduct of this research.

Conflict of interest

The author(s) declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Wallmark, S., Ronne-Engström, E. & Lundström, E. Predicting return to work after subarachnoid hemorrhage using the Montreal Cognitive Assessment (MoCA). Acta Neurochir 158, 233–239 (2016). https://doi.org/10.1007/s00701-015-2665-4

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  • DOI: https://doi.org/10.1007/s00701-015-2665-4

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