Depression after aneurysmal subarachnoid hemorrhage: development of a screening tool and discharge user interface

Authors

• Stefan W. Koester, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
• Brandon K. Hoglund, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
• Joelle N. Hartke, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
• Robert F. Rudy, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
• Ashutosh P. Jadhav, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
• Andrew F. Ducruet, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
• Felipe C. Albuquerque, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
• Joshua S. Catapano, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
• Laura A. Snyder, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
• Michael T. Lawton, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA. Neuropub@barrowneuro.org.

Document Type

Article

Abstract

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Medical Subject Headings

Humans; Subarachnoid Hemorrhage (psychology, complications); Male; Female; Middle Aged; Aged; Depression (diagnosis, etiology); Patient Discharge; Adult; Risk Factors; Mass Screening (methods)

Publication Date

6-24-2025

Publication Title

Acta neurochirurgica

E-ISSN

0942-0940

Volume

167

Issue

1

First Page

176

PubMed ID

40553207

Digital Object Identifier (DOI)

10.1007/s00701-025-06567-8

Recommended Citation

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.; and Lawton, Michael T., "Depression after aneurysmal subarachnoid hemorrhage: development of a screening tool and discharge user interface" (2025). Neurosurgery. 2256.
https://scholar.barrowneuro.org/neurosurgery/2256