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Psychosocial impact of finding small aneurysms that are left untreated in patients previously operated on for ruptured aneurysms

¹ Department of Radiology, University Medical Centre Utrecht, the Netherlands
² From the Department of Neurology, University Medical Centre Utrecht, the Netherlands
³ Julius Centre for General Practice and Patient Oriented Research, University Medical Centre Utrecht, the Netherlands
⁴ Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre Amsterdam, the Netherlands

Correspondence to:
Correspondence to:
Irene C van der Schaaf
Department of Radiology E01.132, University Medical Centre Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands; i.vanderschaaf{at}rrr.azu.nl

Objectives: In patients with previous subarachnoid haemorrhage (SAH) undergoing follow up screening, the authors assessed the impact of finding but not treating very small aneurysms by comparing quality of life (QOL), anxiety, and depression between patients with a newly detected aneurysm that was left untreated (cases) and patients with a negative screening (controls) as this should be incorporated in the evaluation of effectiveness of screening.

Methods: In patients with previous SAH undergoing screening for new aneurysms the authors compared QOL (SF-36, EURO-QOL, and a screening related questionnaire), anxiety, and depression (Hospital Anxiety and Depression Scale (HADS)) between cases and controls. Differences in scores on the SF-36, EURO-QOL, and HADS were assessed with Student’s t test and differences in proportions of patients with HADS scores in the pathological range and screening related changes with ² analysis. The authors powered the study to detect a moderate, clinically relevant difference.

Results: Thirty five cases and 34 controls were included. Trends for health related QOL, anxiety, depression, and consequences in daily life pointed in the same direction of a less favourable situation for cases but all effects were small, and did not reach statistical significance. On the screenings specific questionnaire, cases more often (but not statistically significant) reported changes in daily life.

Conclusions: The authors found no major or moderate impact on QOL, anxiety, and depression of the awareness of having an untreated aneurysm, which was detected at screening, although most items showed a trend towards more negative effects for cases. Minor effects on individual level cannot be excluded by this study.

Abbreviations: HADS, Hospital Anxiety and Depression Scale; QOL, quality of life; SAH, subarachnoid haemorrhage

Keywords: aneurysm; quality of life; SAH; screening

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