Impact of anxiety and mood disorders on elective flow diversion for unruptured intracranial aneurysms: propensity score-matched analyses of two large databases.
Huanwen Chen, Dhairya A Lakhani, Mihir Khunte, Matthew K McIntyre, Chiara Montemitro, Adam A Dmytriw, Sijin Wen, Vivek Yedavalli, Muhammed Amir Essibayi, Hamza Adel Salim, David Altschul, Ajay Malhotra, Marco Colasurdo, Dheeraj Gandhi
{"title":"Impact of anxiety and mood disorders on elective flow diversion for unruptured intracranial aneurysms: propensity score-matched analyses of two large databases.","authors":"Huanwen Chen, Dhairya A Lakhani, Mihir Khunte, Matthew K McIntyre, Chiara Montemitro, Adam A Dmytriw, Sijin Wen, Vivek Yedavalli, Muhammed Amir Essibayi, Hamza Adel Salim, David Altschul, Ajay Malhotra, Marco Colasurdo, Dheeraj Gandhi","doi":"10.1136/jnis-2025-023929","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Anxiety and mood disorders (AMD) may impact the management and outcomes of patients with unruptured intracranial aneurysms (UIAs). This study investigates AMD's associations with utilization and outcomes of endovascular flow diversion (FD).</p><p><strong>Methods: </strong>This was a retrospective analysis of two databases - TriNetX and Nationwide Readmissions Database (NRD, 2020-2022). Patients with newly diagnosed UIA (Cohort 1, TriNetX) and those who underwent elective FD (Cohort 2, NRD) were identified and grouped into AMD and non-AMD controls; 1-to-1 propensity score matching (PSM) was performed to balance groups based on demographics and comorbidities. FD treatment rates within 5 years of UIA diagnosis (Cohort 1) and post-procedure outcomes of elective FD treatments (Cohort 2), including morbidity/mortality (discharge to rehabilitation/death) and stroke, were compared between AMD vs PSM controls.</p><p><strong>Results: </strong>Our search identified 207 198 patients with newly diagnosed UIA (Cohort 1) and 14 220 who underwent elective FD (Cohort 2); ~30% of patients had AMD in both cohorts. In Cohort 1, patients with AMD with newly diagnosed UIA (n=47 381) had significantly higher rates of FD treatment compared with PSM controls (1.9% vs 1.5%, hazard ratio (HR) 1.23 (95% confidence interval (CI) 1.10 to 1.37) p<0.001). In Cohort 2, patients with AMD who underwent elective FD (n=3832) exhibited higher rates of perioperative morbidity/mortality (8.0% vs 4.8%; odds ratio (OR) 1.73 (95% CI 1.23 to 2.44), p=0.002), post-discharge morbidity/mortality (HR 1.63 (95% CI 1.11 to 2.40), p=0.012), perioperative stroke (6.7% vs 4.7%; OR 1.44 (95% CI 1.06 to 1.95), p=0.021), and post-discharge stroke (HR 1.82 (95% CI 1.05 to 3.17), p=0.034) compared with PSM controls.</p><p><strong>Conclusion: </strong>Among UIA patients, AMD is associated with increased FD utilization and worse clinical outcomes following FD.</p>","PeriodicalId":16411,"journal":{"name":"Journal of NeuroInterventional Surgery","volume":" ","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of NeuroInterventional Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/jnis-2025-023929","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NEUROIMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Anxiety and mood disorders (AMD) may impact the management and outcomes of patients with unruptured intracranial aneurysms (UIAs). This study investigates AMD's associations with utilization and outcomes of endovascular flow diversion (FD).
Methods: This was a retrospective analysis of two databases - TriNetX and Nationwide Readmissions Database (NRD, 2020-2022). Patients with newly diagnosed UIA (Cohort 1, TriNetX) and those who underwent elective FD (Cohort 2, NRD) were identified and grouped into AMD and non-AMD controls; 1-to-1 propensity score matching (PSM) was performed to balance groups based on demographics and comorbidities. FD treatment rates within 5 years of UIA diagnosis (Cohort 1) and post-procedure outcomes of elective FD treatments (Cohort 2), including morbidity/mortality (discharge to rehabilitation/death) and stroke, were compared between AMD vs PSM controls.
Results: Our search identified 207 198 patients with newly diagnosed UIA (Cohort 1) and 14 220 who underwent elective FD (Cohort 2); ~30% of patients had AMD in both cohorts. In Cohort 1, patients with AMD with newly diagnosed UIA (n=47 381) had significantly higher rates of FD treatment compared with PSM controls (1.9% vs 1.5%, hazard ratio (HR) 1.23 (95% confidence interval (CI) 1.10 to 1.37) p<0.001). In Cohort 2, patients with AMD who underwent elective FD (n=3832) exhibited higher rates of perioperative morbidity/mortality (8.0% vs 4.8%; odds ratio (OR) 1.73 (95% CI 1.23 to 2.44), p=0.002), post-discharge morbidity/mortality (HR 1.63 (95% CI 1.11 to 2.40), p=0.012), perioperative stroke (6.7% vs 4.7%; OR 1.44 (95% CI 1.06 to 1.95), p=0.021), and post-discharge stroke (HR 1.82 (95% CI 1.05 to 3.17), p=0.034) compared with PSM controls.
Conclusion: Among UIA patients, AMD is associated with increased FD utilization and worse clinical outcomes following FD.
期刊介绍：
The Journal of NeuroInterventional Surgery (JNIS) is a leading peer review journal for scientific research and literature pertaining to the field of neurointerventional surgery. The journal launch follows growing professional interest in neurointerventional techniques for the treatment of a range of neurological and vascular problems including stroke, aneurysms, brain tumors, and spinal compression.The journal is owned by SNIS and is also the official journal of the Interventional Chapter of the Australian and New Zealand Society of Neuroradiology (ANZSNR), the Canadian Interventional Neuro Group, the Hong Kong Neurological Society (HKNS) and the Neuroradiological Society of Taiwan.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
