Clinical Study Quality of Life after Brain Injury (QOLIBRI) Overall Scale for patients after aneurysmal subarachnoid hemorrhage George Kwok Chu Wong a,⇑ , Sandy Wai Lam a , Karine Ngai a , Adrian Wong c , Vincent Mok b , Wai Sang Poon a a Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, China b Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China c Department of Psychological Studies, The Hong Kong Institute of Education, Tai Po, New Territories, Hong Kong, China article info Article history: Received 14 August 2013 Accepted 12 September 2013 Keywords: Cerebral aneurysm Health-related quality of life Stroke Subarachnoid hemorrhage abstract The Quality of Life after Brain Injury Overall Scale (QOLIBRI-OS) is a recently developed instrument that provides a brief summary measure of health-related quality of life (HRQoL) in domains typically affected by brain injury. This study examined the application of the six item QOLIBRI-OS in patients after aneu- rysmal subarachnoid hemorrhage (aSAH). Hong Kong Chinese aSAH patients were evaluated prospec- tively within the chronic phase of 1 year after aSAH in this multi-center observational study. Cronbach’s a was 0.88, and correlations were satisfactory for all six items. QOLIBRI-OS demonstrated good criterion validity with other 1 year outcome assessments. In conclusion, QOLIBRI-OS can be used as a brief index for disease-specific HRQoL assessment after aSAH. Further validation in another popula- tion of aSAH patients is recommended. Ó 2013 Elsevier Ltd. All rights reserved. 1. Introduction Although aneurysmal subarachnoid hemorrhage (aSAH) ac- counts for only 3–5% of all strokes, a high degree of morbidity has been reported in these relatively young patients [1–5]. To over- come the shortcomings in unidimensional aSAH outcome assess- ments, a disease-specific health-related quality of life scale (HRQoL) should be considered. The Quality of Life after Brain Injury (QOLIBRI) assessment has been developed as a descriptive system for HRQoL in brain injury patients. QOLIBRI is a patient-reported outcome instrument consisting of a 37 item scale with six sub- scales covering the areas of physical condition, cognition, emotion, function in daily life, personal and social life, and current situation and future prospects [6,7]. In initial studies of traumatic brain in- jury patients in different countries, QOLIBRI was found to be valid and reliable [8]. To reduce patient burden, the Quality of Life after Brain Injury Overall Scale (QOLIBRI-OS) is a recently developed six item scale that provides a brief summary measure of HRQoL in QOLIBRI do- mains [9]. The QOLIBRI-OS has also been validated for traumatic brain injury and hemorrhage patients [9]. We designed the current study to investigate whether QOLIBRI-OS is also suitable as a HRQoL scale for aSAH patients. 2. Methods This prospective, observational four-center study was carried out in Hong Kong. It is registered with ClinicalTrials.gov of the USA National Institutes of Health (NCT01038193) and was ap- proved by the Joint Chinese University of Hong Kong – New Terri- tories East Cluster Clinical Research Ethics Committee and local Ethics Committees of participating centers. The study conformed to the Declaration of Helsinki, and written informed consent was obtained from all the participants or their next of kin. The patient inclusion criteria were as follows: (1) spontaneous subarachnoid hemorrhage resulting from an angiographically con- firmed intracranial aneurysm; (2) hospital admission within 96 hours of the ictus; (3) aged between 21 and 75 years; (4) Chi- nese (Cantonese) speaking; and (5) willing and able to provide in- formed consent (or availability of a person authorized to do so). The exclusion criteria were as follows: (1) previous cerebrovascu- lar or neurological disease other than an unruptured intracranial aneurysm; (2) neurosurgery prior to the ictus; and (3) inability to cooperate in assessments (unable to obey commands) or aphasic. 2.1. Assessments Outcome assessments were conducted 1 year after ictus (chronic phase) by one of two research assistants (psychology graduates) trained by a post-doctoral research psychologist. 0967-5868/$ - see front matter Ó 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.jocn.2013.09.010 ⇑ Corresponding author. Tel.: +85 2 2632 2624; fax: +85 2 2637 7974. E-mail address: georgewong@surgery.cuhk.edu.hk (G.K.C. Wong). Journal of Clinical Neuroscience 21 (2014) 954–956 Contents lists available at ScienceDirect Journal of Clinical Neuroscience journal homepage: www.elsevier.com/locate/jocn