Hackett Ashia M, Adereti Christopher O, Walker Ariel P, Nico Elsa, Scherschinski Lea, Rhodenhiser Emmajane G, Eberle Adam T, Naik Anant, Giraldo Juan P, Hartke Joelle N, Rahmani Redi, Winkler Ethan A, Catapano Joshua S, Lawton Michael T
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ 85013, USA.
Department of Neurosurgery, Lahey Hospital and Medical Center, Burlington, MA 01805, USA.
Brain Sci. 2024 Apr 18;14(4):394. doi: 10.3390/brainsci14040394.
Racial and socioeconomic health disparities are well documented in the literature. This study examined patient demographics, including socioeconomic status (SES), among individuals presenting with aneurysmal subarachnoid hemorrhage (aSAH) and unruptured intracranial aneurysm (UIA) to identify factors associated with aSAH presentation. A retrospective assessment was conducted of all patients with aSAH and UIA who presented to a large-volume cerebrovascular center and underwent microsurgical treatment from January 2014 through July 2019. Race and ethnicity, insurance type, and SES data were collected for each patient. Comparative analysis of the aSAH and UIA groups was conducted. Logistic regression models were also employed to predict the likelihood of aSAH presentation based on demographic and socioeconomic factors. A total of 640 patients were included (aSAH group, 251; UIA group, 389). Significant associations were observed between race and ethnicity, SES, insurance type, and aneurysm rupture. Non-White race or ethnicity, lower SES, and having public or no insurance were associated with increased odds of aSAH presentation. The aSAH group had poorer functional outcomes and higher mortality rates than the UIA group. Patients who are non-White, have low SES, and have public or no insurance were disproportionately affected by aSAH, which is historically associated with poorer functional outcomes.
种族和社会经济方面的健康差异在文献中有充分记载。本研究调查了患有动脉瘤性蛛网膜下腔出血(aSAH)和未破裂颅内动脉瘤(UIA)的个体的患者人口统计学特征,包括社会经济地位(SES),以确定与aSAH发病相关的因素。对2014年1月至2019年7月期间在一家大型脑血管中心就诊并接受显微手术治疗的所有aSAH和UIA患者进行了回顾性评估。收集了每位患者的种族和族裔、保险类型和SES数据。对aSAH组和UIA组进行了比较分析。还采用逻辑回归模型根据人口统计学和社会经济因素预测aSAH发病的可能性。共纳入640例患者(aSAH组251例;UIA组389例)。观察到种族和族裔、SES、保险类型与动脉瘤破裂之间存在显著关联。非白人种族或族裔、较低的SES以及拥有公共保险或无保险与aSAH发病几率增加相关。aSAH组的功能结局比UIA组差,死亡率也更高。非白人、SES低且拥有公共保险或无保险的患者受aSAH的影响尤为严重,而aSAH在历史上一直与较差的功能结局相关。