Multicenter study of association between socioeconomic status and treatment of ruptured cerebral aneurysms compared to unruptured cerebral aneurysms: insights from 4,517 patients using the area deprivation index

Samhita Bheemireddy; Avi A Gajjar; Mofetoluwa Abe; Amanda Custozzo; Sonia Lipp; Andrew Ringer; Muhammed Amir Essibayi; David Altschul; Oded Goren; Jeffrey Oliver; Jared C Reese; Pouya Entezami; Imran Chaudry; Shawn Manos; Aquilla Scott Turk; Elena Sagues; Andres Gudino; Edgar A Samaniego; Anna Luisa Kühn; Jasmeet Singh; Ajit S Puri; Joanna Mary Roy; Kareem ElNaamani; M. Reid Gooch; Vinay Jaikumar; Adnan H Siddiqui; Alan S Boulos; John C Dalfino; Alexandra R Paul

doi:10.1136/jnis-2024-022935

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Multicenter study of association between socioeconomic status and treatment of ruptured cerebral aneurysms compared to unruptured cerebral aneurysms: insights from 4,517 patients using the area deprivation index

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Multicenter study of association between socioeconomic status and treatment of ruptured cerebral aneurysms compared to unruptured cerebral aneurysms: insights from 4,517 patients using the area deprivation index

Samhita Bheemireddy, Avi A Gajjar, Mofetoluwa Abe, Amanda Custozzo, Sonia Lipp, Andrew Ringer, Muhammed Amir Essibayi, David Altschul, Oded Goren, Jeffrey Oliver, …

Journal of neurointerventional surgery, Vol.18(3), pp.886-892

03/2026

DOI: 10.1136/jnis-2024-022935

PMID: 40157743

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Abstract

BackgroundSocioeconomic status influences health outcomes, including cerebrovascular diseases. Patients from socioeconomically deprived areas may present with more severe conditions due to delayed access to care. This study evaluates the association between neighborhood-level deprivation, measured by the Area Deprivation Index (ADI), and the treatment of ruptured intracranial aneurysms (RIAs) compared with unruptured intracranial aneurysms (UIAs) across multiple centers.MethodsThis retrospective cohort study analyzed data from 4517 patients treated for cerebral aneurysms at 10 US comprehensive stroke centers between 2018 and 2024. Patients were stratified by national ADI decile based on their residential addresses. Multivariable logistic regression was used to examine the relationship between ADI and aneurysm rupture (reference being unruptured aneurysms) and controlled for age, sex, smoking history, family history, and race.ResultsOf 4517 total patients, 1260 (27.9%) underwent treatment of RIAs. Multivariable analysis confirmed ADI as an independent predictor of presentation for treatment of RIA (odds ratio (OR)=1.100, 95% confidence interval (CI)=1.068–1.133, P<0.0001) after adjusting for age, sex, smoking history, and race. This corresponds to a 10% increase in likelihood of presenting for treatment of a ruptured vs unruptured intracranial aneurysm with each ADI decile.ConclusionSocioeconomic deprivation independently predicts treatment of RIAs compared with the treatment of UIAs. These findings highlight disparities in aneurysm detection and management, emphasizing the need for targeted preventive care and accessible screening programs to mitigate the impact of socioeconomic disadvantage on cerebral aneurysm outcomes.

Aneurysm

Hemorrhage

Socioeconomics

Details

Title: Subtitle: Multicenter study of association between socioeconomic status and treatment of ruptured cerebral aneurysms compared to unruptured cerebral aneurysms: insights from 4,517 patients using the area deprivation index
Creators: Samhita Bheemireddy - Albany Medical Center Hospital
Avi A Gajjar - Albany Medical Center Hospital
Mofetoluwa Abe - Albany Medical Center Hospital
Amanda Custozzo - Albany Medical Center Hospital
Sonia Lipp - Mayfield Brain & Spine
Andrew Ringer - Mayfield Brain & Spine
Muhammed Amir Essibayi - Montefiore Medical Center
David Altschul - Montefiore Medical Center
Oded Goren - Geisinger Health System
Jeffrey Oliver - Geisinger Health System
Jared C Reese - Henry Ford Health System
Pouya Entezami - Henry Ford Health System
Imran Chaudry - Prisma Health
Shawn Manos - Prisma Health
Aquilla Scott Turk - Prisma Health
Elena Sagues - University of Iowa
Andres Gudino - University of Iowa
Edgar A Samaniego - Department of Neurology, University of Iowa Health Care, Iowa City, Iowa, USA
Anna Luisa Kühn - University of Massachusetts System
Jasmeet Singh - University of Massachusetts System
Ajit S Puri - University of Massachusetts System
Joanna Mary Roy - Thomas Jefferson University
Kareem ElNaamani - Thomas Jefferson University
M. Reid Gooch - Thomas Jefferson University
Vinay Jaikumar - Department of Neurosurgery, University at Buffalo, Buffalo, New York, USA
Adnan H Siddiqui - University at Buffalo, State University of New York
Alan S Boulos - Albany Medical Center Hospital
John C Dalfino - Albany Medical Center Hospital
Alexandra R Paul - Albany Medical Center Hospital
Resource Type: Journal article
Publication Details: Journal of neurointerventional surgery, Vol.18(3), pp.886-892
DOI: 10.1136/jnis-2024-022935
PMID: 40157743
NLM abbreviation: J Neurointerv Surg
ISSN: 1759-8478
eISSN: 1759-8486
Publisher: BMJ Publishing Group Ltd
Language: English
Electronic publication date: 03/28/2025
Date published: 03/2026
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984802405702771

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