Screening Instrument for Post-Aneurysmal Subarachnoid Hemorrhage Depression

Overview

A simplified 5-point scoring system was developed and validated to predict chronic depression risk after aneurysmal subarachnoid hemorrhage (aSAH). The score stratifies patients into low, medium, and high risk categories, facilitating targeted discharge counseling and improving long-term quality of life.

Background

Aneurysmal subarachnoid hemorrhage (aSAH) is a major cause of spontaneous subarachnoid hemorrhage and contributes significantly to morbidity and mortality worldwide. Approximately 20-30% of aSAH survivors develop long-term psychological sequelae such as depression, which negatively impacts quality of life and employment status. Previous research identified clinical and demographic predictors of post-aSAH depression, but a practical, user-friendly screening tool was lacking. This study aimed to create and validate a simplified scoring system and an online interface to identify patients at risk for chronic depression after aSAH.

Data Highlights

Key Findings

• Chronic depression was present in 29.6% of the 514 patients screened after aSAH.
• A 5-point scoring system was developed based on tobacco use (2 points), COPD (1 point), diabetes (1 point), and an additional factor.
• The scoring system stratifies patients into low, medium, and high risk for chronic depression with increasing relative risk correlating with higher scores.
• The score was validated in an independent cohort of 514 patients, demonstrating good discrimination ability.
• An interactive mobile application was created to facilitate bedside risk assessment and provide patients with tailored counseling resources via QR code.
• Tobacco use and COPD were significantly more prevalent in patients who developed chronic depression post-aSAH.

Clinical Implications

This scoring system enables clinicians to identify aSAH survivors at elevated risk for chronic depression early in the discharge process. Targeted counseling and resource provision can be personalized based on risk category, potentially reducing the incidence and impact of post-aSAH depression. The mobile application facilitates integration into clinical workflows and supports patient engagement in follow-up care.

Conclusion

A validated, simplified scoring tool and user-friendly interface were developed to predict and stratify risk of chronic depression after aSAH. This approach supports improved discharge planning and long-term psychological outcomes in this vulnerable patient population.

References

1. Catapano et al. 2021 -- Post-Aneurysmal Subarachnoid Hemorrhage Depression: Creation of a Screening Instrument and Discharge Interface