Are diagnoses of unruptured intracranial aneurysms associated with quality of life, psychological distress, health anxiety, or use of healthcare services in untreated individuals? A longitudinal, nested case-control study

• Published in: Brain & spine 2024-01, Vol.4, p.102915, Article 102915
• Main Authors: Rosenlund, Ingvild M., Ingebrigtsen, Tor, Johnsen, Liv-Hege, Ringberg, Unni, Mathiesen, Ellisiv B., Isaksen, Jørgen
• Format: Article
• Language: English
• Subjects: Brain; Incidental findings; Intracranial aneurysm; Psychological stress; Quality of life; Screening; Services utilisation
• ISSN: 2772-5294; 2772-5294
• DOI: 10.1016/j.bas.2024.102915

Increasing imaging examination rates leads to a corresponding rise in the detection rates of unruptured intracranial aneurysms (UIAs). There is limited knowledge on how the detection of UIA affects health-related outcomes in untreated patients. Is the diagnosis of UIA associated with psychosocial outcomes, healthcare services utilisation, or sick leave in untreated individuals? Nested case-control study with 96 participants diagnosed with UIAs through magnetic resonance angiography (MRA) screening, not receiving preventive aneurysm obliteration. Comparisons were made with Control1 (192 participants with negative MRAs) and Control2 (192 individuals not MRA screened). Quality of life, psychological distress, and health anxiety were assessed using EQ-5D-5L including EQ VAS, Hopkins Symptom Checklist-10, and Whiteley Index-6, respectively. Healthcare service utilisation and sick leave was measured using registry data. Median follow-up was 32–55 months for the different outcomes. UIA were in general not associated with psychosocial outcomes, neither compared to pre-screening values nor to controls. The exemption was a lower mean EQ VAS score at follow-up for cases (76.7) versus Control1 (80.0), regression coefficient −3.87 (95% CI (−7.60, −0.14). Cases had significantly higher rates of radiology exams compared to controls, with 1.47 (95% CI 1.25, 1.74) exams per person-year versus 0.91 (C95% CI 0.75, 1.09) for Control1 and 0.95 (95% CI CI 0.79, 1.14) for Control2. No significant differences were observed in other psychosocial outcomes, healthcare services utilisation, or sick-leave. The overall impact of untreated UIAs appears to be limited when assessed years after diagnosis. •This study is the first to assess outcomes before and after the diagnosis of unruptured intracranial aneurysms (UIA).•UIA detection was associated with significantly higher radiology exams rates compared to control groups.•UIA detection was not associated with the use of other health care services, long-term psychosocial outcomes, or sick leave.