Demographic, Clinical and Radiological Characteristics
Two hundred patients returned completed questionnaires. All patient information is shown in Table 1 and Table 2. Of the 200 patients, 117 were female, and 83 were male; their mean age was 55.2±9.48 years (range 23–74 years). They had a total of 245 aneurysms (161 patients had one aneurysm, 34 had two, 4 had three, and one had four), and the majority of aneurysms occurred in the anterior circulation (81.5%) (Table 2). A total of 160 (80%) patients underwent stenting or flow diversion (FD), and 40 patients (20%) underwent simple coiling. No technical failures were observed in our cohort, and 8 patients experienced postoperative ischemia-related complications. Among them, one patient with severe postoperative ischemic complications had an mRS of 5 at discharge, and the other patients exhibited good postoperative neurological outcomes (mRS=0-2). All patients presented with good neurological outcomes (mRS=0-2) at follow-up. Ten patients (5%) showed mRS progression at discharge compared with the preoperative mRS score. For all 200 patients, the duration since treatment ranged between 18 and 45 months, with an average of 30.67±8.6 months. Radiological follow-up was available for 167 patients, with a mean follow-up period of 30.76±8.43 months; 7 patients experienced recurrence and had not received further treatment at follow-up.
Table 1. Demographic characteristics of UIAs patients.
Characteristics Value (n, %)
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Age,years,mean±SD 55.2±9.48
Gender (Female) 117 (58.5%)
Hypertension 108 (54.0%)
Diabetes 17 (8.5%)
Heart disease 25 (12.5%)
1ICVD history 37 (18.5)
Smoking 23 (11.5%)
Physical exercise At least once a week 140 (70.0%)
0 time a week 60(30.0%)
Sleep time 6.88±1.19
Education level,years
≤12 131 (65.5%)
>12 69 (34.5%)
Anxiety 34 (17.0%)
Depression 31 (15.5%)
2Ratio
0-100% 133 (66.5%)
>100% 67 (33.5%)
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1ICVD represents “Ischemic cerebrovascular disease”, 2Ratio represents “Ratio of treatment cost to annual household income”
Table 2. Clinical and radiological characteristics of UIA patients.
Characteristics Value(n, %)
|
Diagnosis to treatment time
0-3 months 158 (79.0%)
>3 months 42 (21.0 %)
Intervention materials
Simple coiling 40 (20.0%)
Stent or 1FD 160(80.0%)
mRS progression at discharge No 190 (95.0%)
Yes 10 (5.0%)
Treatment-related complications 8 (4.0%)
Duration since treatment
≤30 months 101 (50.5%)
>30 months 99 (49.5%)
Recurrence 7/167 (4.19%)
Multiple aneurysms 39 (19.5%)
Remain untreated aneurysm
Location
Anterior circulation 163(81.5%)
Posterior circulation 32 (16.0%)
Both 5(2.5%)
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1FD represents “Flow diversion”.
Prevalence and Risk Factors of Anxiety and Depression
As shown in Table 2, of the 200 UIA patients, 34 (17.0%) suffered from anxiety and 31 (15.5%) suffered from depression 30.67±8.6 months after being discharged. Table 3 summarizes the univariate analysis of the determinants of anxiety and depression. The independent variables with P values less than 0.20 in the univariate analysis were included in the multivariate logistic regression analysis. Therefore, anxiety-related variables, including education level, hypertension, ischemic cerebrovascular disease history, location of aneurysm, sleep time and ratio of treatment costs to annual household income, were included; depression-related variables, including gender, sleep time, and ratio of treatment costs to annual household income, were included. Table 4 presents the explanatory variables that were significantly associated with anxiety and depression. The multivariate analysis results indicated that treatment cost exceeding the annual household income was significantly associated with anxiety (AOR = 2.42, 95% CI: 1.08~5.41, P= 0.03). Shorter sleep times were statistically significantly associated with anxiety (AOR = 1.51, 95% CI: 1.06~2.14, P= 0.02) and depression (AOR = 1.62, 95% CI: 1.14~2.29, P= 0.007).
Table 3. Univariate analysis of the anxiety and depression in UIA patients.
Variables Anxiety non-Anxiety P-value Deperssion non-Depression P-value
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Age,years,mean±SD 54.9±8.88 55.25±9.62 0.86 55.26±9.40 55.19±9.52 0.97
Gender (male) 16 (47.1%) 67 (40.4%) 0.47 9 (29.0%) 74 (43.8%) 0.13
Hypertension 23 (67.6%) 85 (51.2%) 0.08 19 (61.3%) 89 (52.7%) 0.44
Diabetes 3 (8.8%) 14 (8.4%) 0.99 3 (9.7%) 14 (8.3%) 0.99
Heart disease 4 (11.8%) 21 (12.7%) 0.99 3 (9.7%) 22 (13..0%) 0.83
1ICVD history 9 (26.5%) 28 (16.9%) 0.19 7 (22.6%) 30 (17.8%) 0.52
Smoking 5 (14.7%) 18 (10.8%) 0.73 3 (9.7%) 20 (11.8%) 0.97
Physical exercise 23 (67.6%) 117 (70.5%) 0.74 19 (61.3%) 121 (71.6%) 0.25
Sleep time 6.53±1.21 6.95±1.18 0.06 6.29±1.22 6.99±1.16 0.003
Education level,years ≤ 12years 26 (76.5%) 105 (63.3%) 0.14 22 (71.0%) 109 (64.5%) 0.49
2Ratio > 100% 17 (50.0%) 50 (30.1%) 0.03 14 (45.2%) 53 (31.4%) 0.14
Diagnosis to treatment time ≤3 months 27 (79.4%) 131 (78.9%) 0.99 25 (80.6%) 133 (78.7%) 0.82
mRS progression at discharge 3 (8.8%) 7 (4.2%) 0.49 3 (9.7%) 7 (4.1%) 0.39
Intervention materials (Stent or 3FD) 29 (85.3%) 131 (78.9%) 0.40 26 (83.9%) 134 (79.3%) 0.56
Treatment-related complications 3 (8.8%) 5 (3.0%) 0.27 1 (3.2%) 7 (4.1%) 0.99
Duration since treatment 31.50±7.82 30.49±8.77 0.54 30.06±8.06 30.78±8.72 0.67
Recurrence 2 (6.7%) 5 (3.6%) 0.81 2 (7.7%) 5 (3.5%) 0.66
Multiple aneurysms 7 (20.6%) 32 (19.3%) 0.99 8 (25.8%) 31 (18.3%) 0.34
Remain untreated aneurysm 1 (2.9%) 9 (5.4%) 0.86 1 (3.2%) 9 (5.3%) 0.96
Location 0.04 0.32
Anterior circulation 23 (67.6%) 140 (84.3%) 24 (77.4%) 139 (82.2%)
Posterior circulation 9 (26.5%) 23 (13.9%) 5 (16.1%) 27 (16.0%)
Both 2 (5.9%) 3 (1.8%) 2 (6.5%) 3 (1.8%)
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1ICVD represents “Ischemic cerebrovascular disease”, 2Ratio represents “Ratio of treatment cost to annual household income” 3FD represents “Flow diversion”.
Table 4. Multivariable analysis of the anxiety and depression in UIA patients.
Variables AOR (95%CI) P-value
|
Anxiety Hypertension 1.99 (0.86~4.61) 0.11
1ICVD history 2.03 (0.77~5.30) 0.15
Education level,years≤12years 1.34 (0.54~3.35) 0.53
2Ratio > 100% 2.42 (1.08~5.41) 0.03
Sleep time 1.51 (1.06~2.14) 0.02
Location
Anterior circulation 1
Posterior circulation 2.21 (0.85~5.71) 0.10
Both 3.50 (0.43~28.49) 0.24
Depression
Gender (Female) 1.51 (0.64~3.59) 0.35
Sleep time 1.62 (1.14~2.29) 0.007
2Ratio > 100% 1.80 (0.80~4.03) 0.15
|
1ICVD represents “Ischemic cerebrovascular disease”, 2Ratio represents “Ratio of treatment cost to annual household income” , AOR represents “Adjusted Odds Ratio”.