Clinical Scorecard: Post-Aneurysmal Subarachnoid Hemorrhage Depression: Creation of a Screening Instrument and Discharge Interface

At a Glance

Key Highlights

• Approximately 29.6% of patients post-aSAH screened positive for chronic depression.
• A simplified 5-point scoring system was developed using tobacco use, COPD, diabetes, and other factors to stratify depression risk.
• An interactive mobile application was created for discharge staff to assess depression risk and provide patient-specific counseling.

Guideline-Based Recommendations

Diagnosis

• Use a screening questionnaire based on SIGECAPS criteria with ≥5 positive responses indicating chronic depression.
• Assess risk factors including tobacco use, COPD, diabetes, aneurysm characteristics, and discharge mRS score.

Management

• Implement patient-specific discharge counseling based on risk stratification from the 5-point scoring system.
• Provide patients with resources and follow-up plans via QR code linked to the mobile application.

Monitoring & Follow-up

• Conduct long-term follow-up depression screening in patients treated for aSAH.
• Monitor neurological and psychiatric sequelae during outpatient visits.

Risks

• Recognize that tobacco use and COPD significantly increase risk of post-aSAH depression.
• Consider comorbidities and aneurysm-related complications as contributors to depression risk.

Patient & Prescribing Data

Patients with aneurysmal subarachnoid hemorrhage treated via endovascular or microsurgical methods

Risk stratification enables targeted counseling to potentially reduce incidence of post-aSAH depression and improve quality of life

Clinical Best Practices

• Screen all eligible aSAH survivors for depression using validated questionnaires during follow-up.
• Utilize the 5-point scoring system to identify patients at low, medium, and high risk for chronic depression.
• Incorporate the mobile application into discharge procedures to facilitate risk communication and resource provision.
• Address modifiable risk factors such as tobacco use during discharge counseling.
• Ensure multidisciplinary follow-up including neurological and psychiatric evaluation.

References

• Catapano et al. Study on post-aSAH depression prediction model
• Barrow Ruptured Aneurysm Trial Database