Complex network populational analysis of comorbidities in patients with ruptured cerebral aneurysms, taking into account sex differences

Background. The population characteristics of comorbidities in patients with subarachnoid hemorrhage (SAH) are insufficiently underlined in the literature. Aim. To test the method of complex network analysis (NA) in studying sex differences in comorbidities among patients with SAH at the population level. Materials and methods. CN analysis was conducted on a population-based «big data» sample, including 628,831 patients. Statistical networks of comorbidities were created for 873 patients with SAH caused by cerebral aneurysms rupture of various localizations. Comorbidities were defined as any additional diagnoses presenting in patients with a ruptured cerebral aneurysm both before and after the SAH event. At the final stage of the CN analysis, all associations of comorbidities with the index diagnosis and with each other were examined for statistical significance. Results. The CN analysis revealed 336 statistically significant associations between diagnostic codes. The number of comorbidities in women was 1.7 times higher than in men. In cases of vertebrobasilar aneurysms, the difference reached 10 times. Arterial hypertension was statistically correlated with the development of SAH only in women. Conclusion. The CN method is applicable for analyzing clinical data at the population level. The analysis revealed that women with SAH have a higher number of comorbidities, particularly in cases of vertebrobasilar aneurysms. Interpretation of the results should consider the limitations and advantages of the method.