Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2025
Exploring the impact of demographics and socioeconomic factors on anxiety, depression and functional outcomes in survivors of aneurysmal subarachnoid hemorrhage.
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Haripottawekul Ariyaporn, Voong Viva, Furie Karen, Mahta Ali
Аннотация
BACKGROUND: The relationship between socioeconomic status (SES) and mental health outcomes in survivors of aneurysmal subarachnoid hemorrhage (aSAH) has not been well explored. We investigated the impact of SES on anxiety and depression at discharge.
METHODS: We performed a retrospective study on a prospectively collected cohort of aSAH patients admitted to an academic center from 2016 to 2024. Data on median household income by zip code areas (5-year estimates for 2022) were taken from the US census. Univariable and multivariable logistic regression analyses were used to assess the associations between SES components and outcomes.
RESULTS: We reviewed 450 cases of aSAH and identified 342 survivors with mean age 57 years (SD 13.7), 63 % female and 71 % white. Of 307 completed screening tests for anxiety (n = 174) and depression (n = 133), anxiety was more common in females (70 % vs. 50 %; p = 0.012), whereas no significant sex difference was observed among patients with depression (59 % males vs. 44 % females; p = 0.09). Higher mRS at discharge (OR 1.29 per each point, 95 % CI 1.01-1.64; p = 0.037) and history of tobacco use (OR 4.58, 95 % CI 1.38-15.2; p = 0.013) were associated with depression at discharge. There was no significant association between neighborhood income quintiles and the presence of anxiety or depression at discharge. Anxiety (OR 2.39, 95 % CI 1.31-4.34; p = 0.004) or depression (OR 2.37, 95 % CI 1.23-4.54; p = 0.01) was associated with had higher modified Rankin Scale at 3 months post-discharge independent of other predictors.
CONCLUSIONS: Although SES factors were not associated with anxiety and depression in survivors of aSAH, larger prospective studies are needed to explore any potential associations. Anxiety or depression at discharge is associated with worse functional outcomes at 3 months post-discharge compared to patients without anxiety or depression.
METHODS: We performed a retrospective study on a prospectively collected cohort of aSAH patients admitted to an academic center from 2016 to 2024. Data on median household income by zip code areas (5-year estimates for 2022) were taken from the US census. Univariable and multivariable logistic regression analyses were used to assess the associations between SES components and outcomes.
RESULTS: We reviewed 450 cases of aSAH and identified 342 survivors with mean age 57 years (SD 13.7), 63 % female and 71 % white. Of 307 completed screening tests for anxiety (n = 174) and depression (n = 133), anxiety was more common in females (70 % vs. 50 %; p = 0.012), whereas no significant sex difference was observed among patients with depression (59 % males vs. 44 % females; p = 0.09). Higher mRS at discharge (OR 1.29 per each point, 95 % CI 1.01-1.64; p = 0.037) and history of tobacco use (OR 4.58, 95 % CI 1.38-15.2; p = 0.013) were associated with depression at discharge. There was no significant association between neighborhood income quintiles and the presence of anxiety or depression at discharge. Anxiety (OR 2.39, 95 % CI 1.31-4.34; p = 0.004) or depression (OR 2.37, 95 % CI 1.23-4.54; p = 0.01) was associated with had higher modified Rankin Scale at 3 months post-discharge independent of other predictors.
CONCLUSIONS: Although SES factors were not associated with anxiety and depression in survivors of aSAH, larger prospective studies are needed to explore any potential associations. Anxiety or depression at discharge is associated with worse functional outcomes at 3 months post-discharge compared to patients without anxiety or depression.