Clinical Research Intern Barrow Neurological Institute
Introduction: Cerebral vasospasm (cVSP) is a common complication of aneurysmal subarachnoid hemorrhage (aSAH) and is associated with poor clinical outcomes. The relevance of sociodemographic factors on the incidence of cVSP in patients suffering from aSAH is unclear. We sought to determine the impact of sociodemographic variables on cVSP.
Methods: Patients treated for aSAH at a single-quaternary care center between November 2007 through September 2017 were retrospectively analyzed. Race/Ethnicity, insurance type and SES were extracted from the patient charts. SES data was derived from using patients' addresses and an Area Deprivation Index (ADI). ADI scores were used to categorize patients as either moderately- to-highly disadvantaged or low disadvantaged. The primary outcome was vasospasm status post aSAH treatment. Firth’s logistic regression was used to perform a multivariate propensity score adjustment, using patients’ demographics, comorbidities, and postoperative aneurysm size.
Results: A total of 255 patients were included in the analysis, of which 177 (69%) were considered moderately-to-highly disadvantaged. Patients in the more disadvantaged group had a higher incidence (76.8%) of vasospasm (SMD = 0.309, p = 0.031). Patients who were uninsured vs patients with private insurance had increased odds of vasospasms (OR = 3.249, 95 CI: 1.178 – 10.458, p = 0.022). There were no significant differences in vasospasm based on Race & Ethnicity.
Conclusion : Patients of low socioeconomic status more frequently suffer from cVSP and are at increased odds. Further research with larger cohorts and more diverse populations is necessary to assess the association of sociodemographic factors with cVSP and determine solutions to this health disparity.
