Koester Stefan W, Hoglund Brandon K, Hartke Joelle N, Rudy Robert F, Jadhav Ashutosh P, Ducruet Andrew F, Albuquerque Felipe C, Catapano Joshua S, Snyder Laura A, Lawton Michael T
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
Acta Neurochir (Wien). 2025 Jun 24;167(1):176. doi: 10.1007/s00701-025-06567-8.
A method for identification of chronic depression after aneurysmal subarachnoid hemorrhage (aSAH), risk stratification, and counseling is needed. This study aimed to develop a scoring system for post-aSAH depression and a user interface to supplement discharge counseling for patients.
Based on a published prediction model for posttreatment depression risk among aSAH patients, a scale was developed using the beta coefficients of the final predictive model. The 5-point scale was based on 4 characteristics: tobacco use (2 points), chronic obstructive pulmonary disease (1 point), diabetes (1 point), and nonsaccular aneurysm type (1 point). A score of 1 was defined as low risk, a score of 2 or 3 was defined as medium risk, and a score of 4 or 5 was defined as high risk. The scale was then validated in a cohort of 514 patients treated at a single center. An interactive application was developed.
The rate of posttreatment depression among aSAH patients was 29.6% (152 of 514). The low-risk group had a nonsignificant increase in depression risk (relative risk [RR] [95% CI] = 0.89 [0.59-1.33], p = 0.71) compared with those with a score of 0. Significant increases in depression risk were found in the medium-risk (RR [95% CI] = 1.78 [1.34-2.37], p < 0.001) and high-risk (RR [95% CI] = 2.29 [1.28-4.09], p < 0.001) groups.
A substantial percentage of patients in our cohort experienced major depressive disorder symptoms after aSAH treatment. An easy-to-use prediction and risk stratification tool for posttreatment depression among aSAH patients is available.
需要一种用于识别动脉瘤性蛛网膜下腔出血（aSAH）后慢性抑郁、风险分层及咨询的方法。本研究旨在开发一种aSAH后抑郁的评分系统以及一个用户界面，以辅助对患者的出院咨询。
基于已发表的aSAH患者治疗后抑郁风险预测模型，利用最终预测模型的β系数开发了一个量表。该5分量表基于4个特征：吸烟（2分）、慢性阻塞性肺疾病（1分）、糖尿病（1分）和非囊状动脉瘤类型（1分）。将1分定义为低风险，2分或3分定义为中等风险，4分或5分定义为高风险。然后在一个单中心治疗的514例患者队列中对该量表进行验证。开发了一个交互式应用程序。
aSAH患者治疗后抑郁发生率为29.6%（514例中的152例）。与得分为0的患者相比，低风险组的抑郁风险增加不显著（相对风险[RR][95%CI]=0.89[0.59 - 1.33]，p = 0.71）。中等风险组（RR[95%CI]=1.78[1.34 - 2.37]，p<0.001）和高风险组（RR[95%CI]=2.29[1.28 - 4.09]，p<0.001）的抑郁风险显著增加。
我们队列中的相当一部分患者在aSAH治疗后出现了重度抑郁症症状。有一个易于使用的aSAH患者治疗后抑郁预测和风险分层工具。
