Mid-to-long-term quality of life and psychological status after endovascular embolization of unruptured intracranial aneurysms
Journal Title: Chinese Journal of Nervous and Mental Diseases - Year 2024, Vol 50, Issue 7
Abstract
[Objective] To investigate whether embolization surgery can improve mid-to-long-term outcomes related to quality of life, anxiety and depression in patients with unruptured intracranial aneurysms (UIA). [Methods] This prospective study included patients diagnosed with UIA within 30 days. Patients were divided into two groups based on treatment: the embolization group and the conservative group. The assessments of quality of life, depression, and anxiety were conducted using the medical outcome study short form-36 (SF-36), self-rating depression scale (SDS), and self-rating anxiety scale (SAS) at baseline, 3 months, and 5 years after treatment. In the embolization group, psychological trauma was assessed using the impact of event scale-revised (IES-R) at 3 months and 5 years post-surgery. [Results] A total of 113 patients were involved in the analysis including 76 in the embolization group and 37 in the conservative group. Compared to the conservative group, SF-36 data showed that the embolization group had a lower physical function (80.3±16.4 vs. 86.1±12.8, P=0.046) and role-physical (47.37±43.32 vs. 67.57±34.29, P=0.015) scores at 3 months, but a higher mental health score (68.16±18.80 vs. 61.62±14.62, P=0.048). At 5 years, all dimensions of SF-36 improved significantly compared to baseline (all P<0.05). The SDS and SAS scores in the embolization group were significantly lower at both 3 months and 5 years compared to baseline (both P<0.05). The decrease in SDS (-2.8±10.6 vs. 0.5±6.5) and SAS (-2.7±11.8 vs. 1.2±5.4) scores in the embolization group at 3 months was greater than in the conservative group (both P<0.05). Subgroup analysis showed that patients with depression or anxiety at baseline in the embolization group experienced a significant decrease in SDS and SAS scores at 3 months and 5 years compared to baseline (both P<0.05). Additionally, in the embolization group, the IES-R score at 3 months was 37.5±13.8, which was significantly higher than the critical threshold (P=0.005), but decreased to 33.8±13.3 at 5 years post-surgery. [Conclusions] Patients with unruptured intracranial aneurysms experienced long-term improvements in quality of life after embolization surgery. Embolization surgery also helped alleviate depression and anxiety.
Authors and Affiliations
Guofeng ZHANG, Zhimei LI, Lin XU, Weiping XIAO, Siqi OU, Tiewei QI, Feng LIANG, Lei. SHI
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