Follow-up care compliance among patients diagnosed with unruptured intracranial aneurysms.

Autor: Kaur H; Department of Neurosurgery, University of California, Irvine, CA, United States., Yuki I; Department of Neurosurgery, University of California, Irvine, CA, United States. Electronic address: iyuki@hs.uci.edu., Shimizu T; Department of Neurosurgery, University of California, Irvine, CA, United States., Paganini-Hill A; Department of Neurology, University of California, Irvine, CA, United States., Xu J; Department of Neurosurgery, University of California, Irvine, CA, United States., Golshani K; Department of Neurosurgery, University of California, Irvine, CA, United States., Hsu FPK; Department of Neurosurgery, University of California, Irvine, CA, United States., Nguyen T; Department of Neurosurgery, University of California, Irvine, CA, United States., Jin CM; Department of Neurosurgery, University of California, Irvine, CA, United States., Suzuki S; Department of Neurosurgery, University of California, Irvine, CA, United States.
Jazyk: angličtina
Zdroj: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2024 Aug; Vol. 33 (8), pp. 107786. Date of Electronic Publication: 2024 May 21.
DOI: 10.1016/j.jstrokecerebrovasdis.2024.107786
Abstrakt: Objectives: Periodic imaging follow-up for patients with unruptured intracranial aneurysms (UIA) is crucial, as studies indicate higher rupture risk with aneurysm growth. However, few studies address patient adherence to follow-up recommendations. This study aims to identify compliance rates and factors influencing follow-up adherence.
Methods: Patients with a UIA were identified from our institution's database from 2011-2021. Follow-up imaging (CT/MR Angiogram) was advised at specific intervals. Patients were categorized into compliant and non-compliant groups based on first-year compliance. Factors contributing to compliance were assessed through multivariate logistic regression. Phone interviews were conducted with non-compliant patients to understand reasons for non-adherence.
Results: Among 923 UIA diagnosed patients, 337 were randomly selected for analysis. The median follow-up period was 1.4 years, with a 42% first-year compliance rate. The mean aneurysm size was 3.3 mm. Five patients had a rupture during follow-up, of which 4 died. Compared with patients consulting specialists at the initial diagnosis, those seen by non-specialists exhibited lower compliance (OR 0.25, p < 0.001). Loss to follow-up was greatest during transition from emergency service to specialist appointments. Patients who spoke languages other than English exhibited poorer compliance than those speaking English (OR 0.20, p = 0.01).
Conclusions: Significant amounts of UIA patients at low rupture risk were lost to follow-up before seeing UIA specialists. Main non-compliance factors include inadequate comprehension of follow-up instructions, poor care transfer from non-specialists to specialist, and insurance barriers.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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