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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Postdiagnostic Anxiety and Depression Increase Rupture Risk and Mortality in Unruptured Intracranial Aneurysms.

Muhammed Amir Essibayi1, Ahmed Y Azzam2, Hamza Adel Salim3,4

  • 1Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (M.A.E., A.K., D.K., N.H., D.J.A.).

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Anxiety and depression diagnoses in patients with unruptured intracranial aneurysms are linked to higher mortality and rupture risks. Integrated psychiatric assessment may improve patient management and outcomes.

Keywords:
anxietychronic diseasedepressionintracranial aneurysmrupture

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Area of Science:

  • Neurology and Psychiatry
  • Epidemiology
  • Health Services Research

Background:

  • The impact of postdiagnostic anxiety and depression on outcomes for patients with unruptured intracranial aneurysms (UIAs) is not well understood.
  • This study investigates the association between anxiety/depression and treatment patterns/outcomes in a large UIA patient cohort.

Purpose of the Study:

  • To assess the association between postdiagnostic anxiety and depression and outcomes in patients with unruptured intracranial aneurysms.
  • To evaluate the impact on mortality, aneurysm rupture, and treatment patterns.

Main Methods:

  • Retrospective cohort study using the TriNetX Global Collaborative Network (2015-2025) with over 130 million patients.
  • Identified 127,361 adults with UIAs, employing a 127-day landmark analysis to mitigate immortal time bias.
  • 1:1 propensity score matching created cohorts of 6800 patients with anxiety/depression and 6800 controls for outcome analysis using Cox proportional hazards models.

Main Results:

  • Anxiety/depression was associated with significantly higher all-cause mortality (HR 1.28) and aneurysm rupture (HR 1.33).
  • Five-year survival was lower in the anxiety/depression cohort (93.7%) compared to controls (95.5%).
  • A dose-response relationship was observed between psychiatric medication adherence and mortality risk.

Conclusions:

  • Postdiagnostic anxiety and depression are linked to increased mortality and rupture risk in UIA patients.
  • Findings suggest considering integrated psychiatric assessments in the management of unruptured intracranial aneurysms.
  • Further research is needed to establish causality and refine management strategies.