Analysis of nonmodifiable risk factors for intracranial aneurysm rupture in a large, retrospective cohort.
Publication/Presentation Date
3-1-2012
Abstract
BACKGROUND: The risk factors predictive of intracranial aneurysm rupture remain incompletely defined.
OBJECTIVE: To examine the association between various nonmodifiable risk factors and aneurysm rupture in a large cohort of patients evaluated at a single institution.
METHODS: A retrospective analysis of patients admitted to a cerebrovascular facility between January 2006 and 2010 with a primary diagnosis of cerebral aneurysm. Aneurysms were divided into 2 groups: unruptured or ruptured. The dome diameter, aspect ratio (AR), location, sidedness, neck morphology, and multiplicity were entered into a central database. A full model was constructed, and a systematic removal of the least significant variables was performed in a sequential fashion until only those variables reaching significance remained.
RESULTS: We identified 2347 patients harboring 5134 individual aneurysms, of which 34.90% were ruptured and 65.09% were unruptured. On admission, 25.89% of aneurysms with a dome diameter < 10 mm and 58.33% of aneurysms with a dome >10 mm were ruptured (P < .001). Of aneurysms with an AR >1.6, 52.44% presented following a rupture (P < .001). The highest incidence of rupture (69.21%) was observed in aneurysms with an AR >1.6, dome diameter < 10 mm, and a deviated neck. Deviated neck-type aneurysms had a significantly greater incidence of rupture than classical neck-type aneurysms (P < .001).
CONCLUSION: An AR >1.6, dome diameter >10 mm, a deviated neck, and right-sidedness are independently associated with aneurysm rupture.
Volume
70
Issue
3
First Page
693
Last Page
699
ISSN
1524-4040
Published In/Presented At
Amenta, P. S., Yadla, S., Campbell, P. G., Maltenfort, M. G., Dey, S., Ghosh, S., Ali, M. S., Jallo, J. I., Tjoumakaris, S. I., Gonzalez, L. F., Dumont, A. S., Rosenwasser, R. H., & Jabbour, P. M. (2012). Analysis of nonmodifiable risk factors for intracranial aneurysm rupture in a large, retrospective cohort. Neurosurgery, 70(3), 693–701. https://doi.org/10.1227/NEU.0b013e3182354d68
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
21904261
Department(s)
Administration and Leadership
Document Type
Article