|Paper title||Measuring the impact of delayed cerebral ischemia on neuropsychological outcome after aneurysmal subarachnoid haemorrhage – protocol of a Swiss nationwide observational study (MoCA – DCI study)|
|Form of presentation||Poster|
Aims: Delayed cerebral ischemia (DCI) could be identified as an important predictor of neuropsychological impairment following aneurysmal subarachnoid haemorrhage (aSAH) in single-centre studies. All previous studies lacked a baseline neuropsychological assessment before DCI onset. Neuropsychological evaluation of acutely ill patients is often applied in a busy intensive care unit (ICU), where distraction represents a bias to the obtained results. The objective of this study is to evaluate the relationship between DCI and neuropsychological outcome after aSAH by comparing the Montreal Cognitive Assessment (MoCA) results in aSAH patients with and without DCI immediately after the DCI-period and at 3 months with the baseline examination before the DCI-period (part 1). A further objective is to determine the reliability of the MoCA, when applied in an ICU setting (part 2).
Methods: This is a prospective, multicentre, observational study performed at all Swiss neurovascular centres treating patients with aSAH. For part 1, a total number of n=240 consecutively recruited aSAH patients and for part 2 n=50 patients with acute brain injury are recruited. Outcome measures for part 1 are the MoCA, the modified Rankin scale (mRS), EuroQol (EQ5D), and home time. Part 2 of the study applies reliability measures for the MoCA.
Results: The institutional review board (Kantonale Ethikkommission Zürich (KEK-ZH)) approved this study on July 4th 2017 under case number 2017-00103. After completion of the study, the results will be offered to an international scientific journal for peer-reviewed publication. This study determines the exact impact of DCI on the neuropsychological outcome after aSAH, unbiased by confounding factors such as early brain injury or patient-specific characteristics. The study provides unique insights in the neuropsychological state of patients in the early period after aSAH. In this presentation, focus is laid on the methods of this Swiss collaborative multi center study, but the current state of recruitment and some illustrative patient examples are given.
Conclusion: This study is an example of how collaborative studies in clinical neuroscience can be conducted, using well-established structures such as the Swiss SOS study group. The study is currently on track and recruitment is on-going
Trial registration: The study is registered with the ClinicalTrials.gov identifier: NCT03032471.