Abstract:
Racial and socioeconomic health disparities are well documented in the literature. This study examined patient demographics, including socioeconomic status (SES), among individuals presenting with aneurysmal subarachnoid hemorrhage (aSAH) and unruptured intracranial aneurysm (UIA) to identify factors associated with aSAH presentation. A retrospective assessment was conducted of all patients with aSAH and UIA who presented to a large-volume cerebrovascular center and underwent microsurgical treatment from January 2014 through July 2019. Race and ethnicity, insurance type, and SES data were collected for each patient. Comparative analysis of the aSAH and UIA groups was conducted. Logistic regression models were also employed to predict the likelihood of aSAH presentation based on demographic and socioeconomic factors. A total of 640 patients were included (aSAH group, 251; UIA group, 389). Significant associations were observed between race and ethnicity, SES, insurance type, and aneurysm rupture. Non-White race or ethnicity, lower SES, and having public or no insurance were associated with increased odds of aSAH presentation. The aSAH group had poorer functional outcomes and higher mortality rates than the UIA group. Patients who are non-White, have low SES, and have public or no insurance were disproportionately affected by aSAH, which is historically associated with poorer functional outcomes.
摘要:
种族和社会经济健康差异在文献中有很好的记录。这项研究检查了患者的人口统计学,包括社会经济地位(SES),在表现为动脉瘤性蛛网膜下腔出血(aSAH)和未破裂颅内动脉瘤(UIA)的个体中,确定与aSAH表现相关的因素.对2014年1月至2019年7月到大容量脑血管中心并接受显微外科治疗的所有aSAH和UIA患者进行了回顾性评估。种族和民族,保险类型,收集每位患者的SES数据.对aSAH和UIA组进行比较分析。Logistic回归模型也被用来预测基于人口统计学和社会经济因素的aSAH表现的可能性。共纳入640例患者(aSAH组,251;UIA集团,389).在种族和种族之间观察到显着的关联,SES,保险类型,动脉瘤破裂.非白人种族或种族,较低的SES,并且有公共保险或没有保险与aSAH出现的几率增加相关.与UIA组相比,aSAH组的功能结局较差,死亡率更高。非白人患者,SES低,公共或没有保险受到aSAH的不成比例的影响,这在历史上与较差的功能结果相关。