Abstract T P356: Predictors of Depression 6 Months After Aneurysmal Subarachnoid Hemorrhage

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Background: Functional outcome is of increasing importance among survivors of aneurysmal subarachnoid hemorrhage (SAH). Depression is commonly reported after stroke and may play a significant role in functional recovery after SAH. Our goal was to determine the prevalence and predictors of depression among survivors of SAH at 6 months. Methods: Six-month follow up data was analyzed from a cohort study of SAH patients at a tertiary care center. With IRB approval and consent, patients completed serial 6-month outcome assessments including the Modified Rankin Scale (mRS) and the Hospital Anxiety and Depression Scale (HADS). Independent predictors of poor functional (mRS>2) and mood outcomes (HADS≥10) were determined using univariate and multivariate statistics. Results: Of 247 subjects (74% female, mean age 55), 7% had poor functional outcome. Depression was reported in 17%. Poor functional outcome was significantly associated with a longer hospitalization (mean 26 days, p=0.02), placement of an EVD and VP shunt (p=0.008 & 0.02) and antibiotic use (p=0.001). Depression was significantly associated with poor functional outcome, prior history of depression, and vasospasm (p=0.001, 0.004 & 0.05). Depression showed a trend in those who received an EVD, ventilator, and antibiotics. Depression was not significantly associated with treatment modality. Multivariate logistic analyses demonstrated that poor functional outcome (OR=5.25, CI=1.44-19.10, p=0.01), history of depression (OR=7.66, CI=1.87-31.45, p=0.005), and vasospasm (OR=2.65, CI=1.04-6.75, p=0.04) remain significant predictors of depression, however, EVD, ventilator, antibiotics, and Hunt Hess Grade are not significant. Conclusion: Depression is not uncommon after SAH, and highly associated with poor neurological recovery at 6 months. Risk factors for development of depression include prior history of depression and cerebral vasospasm. Based on these results, we recommend screening for depression and consideration for early treatment for patients at highest risk after SAH.