Analysis of Nonmodifiable Risk Factors for Intracranial Aneurysm Rupture in a Large, Retrospective Cohort
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 retrospecti...
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| Veröffentlicht in: | Neurosurgery 2012-03, Vol.70 (3), p.693-701 |
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| creator | Amenta, Peter S. Yadla, Sanjay Campbell, Peter G. Maltenfort, Mitchell G. Dey, Saugat Ghosh, Sayantani Ali, Muhammad S. Jallo, Jack I. Tjoumakaris, Stavropoula I. Gonzalez, L. Fernando Dumont, Aaron S. Rosenwasser, Robert H. Jabbour, Pascal M. |
| description | 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 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 1.6, dome diameter >10 mm, a deviated neck, and right-sidedness are independently associated with aneurysm rupture. |
| doi_str_mv | 10.1227/NEU.0b013e3182354d68 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_923188688</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1227/NEU.0b013e3182354d68</oup_id><sourcerecordid>2356874810</sourcerecordid><originalsourceid>FETCH-LOGICAL-c591t-6c59c6a46f53e65a6068a3c8eeb8f175fac57c1e14b3002e4503e91eb15218243</originalsourceid><addsrcrecordid>eNqNkU1r3DAQhkVpaTZJ_0EpghJyqRON9WH5uCxJG1hSWBrIzcjaUavEthzJLuy_r8puG8gpp7k88w7zvIR8BHYBZVld3l7dXbCWAUcOuuRSbJV-QxYgS1EIJthbsmAgdMFrdX9EjlN6YAyUqPR7clRCzUSpYEH8cjDdLvlEg6O3YejD1jtv2g7pxqdHem3sFGKiLkR6M0zR2GgGbzq6HHCOu9TTzTxOc0TqB2ro2sSf-IVucIohjWgn_xvpKvwKcTol75zpEn44zBNyd331Y_WtWH__erNargsra5gKlYdVRignOSppFFPacKsRW-2gks5YWVlAEC1nrEQhGccasM2PZw-Cn5Dzfe4Yw9OMaWp6nyx2nRkwzKmpy-xLK60z-fkF-RDmmH2kJvtUuhIaWKbEnrL5pRTRNWP0vYm7Bljzt4kmN9G8bCKvfTqEz22P2_9L_9Rn4OwAmGRN57JX69MzJ6UEqKrMXe65MI-vO_0HzJeffQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2356874810</pqid></control><display><type>article</type><title>Analysis of Nonmodifiable Risk Factors for Intracranial Aneurysm Rupture in a Large, Retrospective Cohort</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Amenta, Peter S. ; Yadla, Sanjay ; Campbell, Peter G. ; Maltenfort, Mitchell G. ; Dey, Saugat ; Ghosh, Sayantani ; Ali, Muhammad S. ; Jallo, Jack I. ; Tjoumakaris, Stavropoula I. ; Gonzalez, L. Fernando ; Dumont, Aaron S. ; Rosenwasser, Robert H. ; Jabbour, Pascal M.</creator><creatorcontrib>Amenta, Peter S. ; Yadla, Sanjay ; Campbell, Peter G. ; Maltenfort, Mitchell G. ; Dey, Saugat ; Ghosh, Sayantani ; Ali, Muhammad S. ; Jallo, Jack I. ; Tjoumakaris, Stavropoula I. ; Gonzalez, L. Fernando ; Dumont, Aaron S. ; Rosenwasser, Robert H. ; Jabbour, Pascal M.</creatorcontrib><description>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 necktype aneurysms (P < .001).
Conclusion:
An AR >1.6, dome diameter >10 mm, a deviated neck, and right-sidedness are independently associated with aneurysm rupture.</description><identifier>ISSN: 0148-396X</identifier><identifier>EISSN: 1524-4040</identifier><identifier>DOI: 10.1227/NEU.0b013e3182354d68</identifier><identifier>PMID: 21904261</identifier><identifier>CODEN: NRSRDY</identifier><language>eng</language><publisher>Hagerstown, MD: Oxford University Press</publisher><subject>Aneurysm, Ruptured - diagnostic imaging ; Aneurysm, Ruptured - epidemiology ; Aneurysms ; Biological and medical sciences ; Cerebral Angiography ; Cerebrovascular Circulation ; Cohort Studies ; Databases, Factual - statistics & numerical data ; Humans ; Incidence ; Intracranial Aneurysm - diagnostic imaging ; Intracranial Aneurysm - epidemiology ; Medical sciences ; Neurosurgery ; Retrospective Studies ; Risk Assessment - methods ; Risk Factors ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><ispartof>Neurosurgery, 2012-03, Vol.70 (3), p.693-701</ispartof><rights>Copyright © 2011 by the Congress of Neurological Surgeons 2011</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 by the Congress of Neurological Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c591t-6c59c6a46f53e65a6068a3c8eeb8f175fac57c1e14b3002e4503e91eb15218243</citedby><cites>FETCH-LOGICAL-c591t-6c59c6a46f53e65a6068a3c8eeb8f175fac57c1e14b3002e4503e91eb15218243</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25551177$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21904261$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Amenta, Peter S.</creatorcontrib><creatorcontrib>Yadla, Sanjay</creatorcontrib><creatorcontrib>Campbell, Peter G.</creatorcontrib><creatorcontrib>Maltenfort, Mitchell G.</creatorcontrib><creatorcontrib>Dey, Saugat</creatorcontrib><creatorcontrib>Ghosh, Sayantani</creatorcontrib><creatorcontrib>Ali, Muhammad S.</creatorcontrib><creatorcontrib>Jallo, Jack I.</creatorcontrib><creatorcontrib>Tjoumakaris, Stavropoula I.</creatorcontrib><creatorcontrib>Gonzalez, L. Fernando</creatorcontrib><creatorcontrib>Dumont, Aaron S.</creatorcontrib><creatorcontrib>Rosenwasser, Robert H.</creatorcontrib><creatorcontrib>Jabbour, Pascal M.</creatorcontrib><title>Analysis of Nonmodifiable Risk Factors for Intracranial Aneurysm Rupture in a Large, Retrospective Cohort</title><title>Neurosurgery</title><addtitle>Neurosurgery</addtitle><description>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 necktype aneurysms (P < .001).
Conclusion:
An AR >1.6, dome diameter >10 mm, a deviated neck, and right-sidedness are independently associated with aneurysm rupture.</description><subject>Aneurysm, Ruptured - diagnostic imaging</subject><subject>Aneurysm, Ruptured - epidemiology</subject><subject>Aneurysms</subject><subject>Biological and medical sciences</subject><subject>Cerebral Angiography</subject><subject>Cerebrovascular Circulation</subject><subject>Cohort Studies</subject><subject>Databases, Factual - statistics & numerical data</subject><subject>Humans</subject><subject>Incidence</subject><subject>Intracranial Aneurysm - diagnostic imaging</subject><subject>Intracranial Aneurysm - epidemiology</subject><subject>Medical sciences</subject><subject>Neurosurgery</subject><subject>Retrospective Studies</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><issn>0148-396X</issn><issn>1524-4040</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkU1r3DAQhkVpaTZJ_0EpghJyqRON9WH5uCxJG1hSWBrIzcjaUavEthzJLuy_r8puG8gpp7k88w7zvIR8BHYBZVld3l7dXbCWAUcOuuRSbJV-QxYgS1EIJthbsmAgdMFrdX9EjlN6YAyUqPR7clRCzUSpYEH8cjDdLvlEg6O3YejD1jtv2g7pxqdHem3sFGKiLkR6M0zR2GgGbzq6HHCOu9TTzTxOc0TqB2ro2sSf-IVucIohjWgn_xvpKvwKcTol75zpEn44zBNyd331Y_WtWH__erNargsra5gKlYdVRignOSppFFPacKsRW-2gks5YWVlAEC1nrEQhGccasM2PZw-Cn5Dzfe4Yw9OMaWp6nyx2nRkwzKmpy-xLK60z-fkF-RDmmH2kJvtUuhIaWKbEnrL5pRTRNWP0vYm7Bljzt4kmN9G8bCKvfTqEz22P2_9L_9Rn4OwAmGRN57JX69MzJ6UEqKrMXe65MI-vO_0HzJeffQ</recordid><startdate>20120301</startdate><enddate>20120301</enddate><creator>Amenta, Peter S.</creator><creator>Yadla, Sanjay</creator><creator>Campbell, Peter G.</creator><creator>Maltenfort, Mitchell G.</creator><creator>Dey, Saugat</creator><creator>Ghosh, Sayantani</creator><creator>Ali, Muhammad S.</creator><creator>Jallo, Jack I.</creator><creator>Tjoumakaris, Stavropoula I.</creator><creator>Gonzalez, L. Fernando</creator><creator>Dumont, Aaron S.</creator><creator>Rosenwasser, Robert H.</creator><creator>Jabbour, Pascal M.</creator><general>Oxford University Press</general><general>Lippincott Williams & Wilkins</general><general>Wolters Kluwer Health, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20120301</creationdate><title>Analysis of Nonmodifiable Risk Factors for Intracranial Aneurysm Rupture in a Large, Retrospective Cohort</title><author>Amenta, Peter S. ; Yadla, Sanjay ; Campbell, Peter G. ; Maltenfort, Mitchell G. ; Dey, Saugat ; Ghosh, Sayantani ; Ali, Muhammad S. ; Jallo, Jack I. ; Tjoumakaris, Stavropoula I. ; Gonzalez, L. 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Transplantations, organ and tissue grafts. Graft diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Amenta, Peter S.</creatorcontrib><creatorcontrib>Yadla, Sanjay</creatorcontrib><creatorcontrib>Campbell, Peter G.</creatorcontrib><creatorcontrib>Maltenfort, Mitchell G.</creatorcontrib><creatorcontrib>Dey, Saugat</creatorcontrib><creatorcontrib>Ghosh, Sayantani</creatorcontrib><creatorcontrib>Ali, Muhammad S.</creatorcontrib><creatorcontrib>Jallo, Jack I.</creatorcontrib><creatorcontrib>Tjoumakaris, Stavropoula I.</creatorcontrib><creatorcontrib>Gonzalez, L. Fernando</creatorcontrib><creatorcontrib>Dumont, Aaron S.</creatorcontrib><creatorcontrib>Rosenwasser, Robert H.</creatorcontrib><creatorcontrib>Jabbour, Pascal M.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Amenta, Peter S.</au><au>Yadla, Sanjay</au><au>Campbell, Peter G.</au><au>Maltenfort, Mitchell G.</au><au>Dey, Saugat</au><au>Ghosh, Sayantani</au><au>Ali, Muhammad S.</au><au>Jallo, Jack I.</au><au>Tjoumakaris, Stavropoula I.</au><au>Gonzalez, L. Fernando</au><au>Dumont, Aaron S.</au><au>Rosenwasser, Robert H.</au><au>Jabbour, Pascal M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analysis of Nonmodifiable Risk Factors for Intracranial Aneurysm Rupture in a Large, Retrospective Cohort</atitle><jtitle>Neurosurgery</jtitle><addtitle>Neurosurgery</addtitle><date>2012-03-01</date><risdate>2012</risdate><volume>70</volume><issue>3</issue><spage>693</spage><epage>701</epage><pages>693-701</pages><issn>0148-396X</issn><eissn>1524-4040</eissn><coden>NRSRDY</coden><abstract>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 necktype aneurysms (P < .001).
Conclusion:
An AR >1.6, dome diameter >10 mm, a deviated neck, and right-sidedness are independently associated with aneurysm rupture.</abstract><cop>Hagerstown, MD</cop><pub>Oxford University Press</pub><pmid>21904261</pmid><doi>10.1227/NEU.0b013e3182354d68</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0148-396X |
| ispartof | Neurosurgery, 2012-03, Vol.70 (3), p.693-701 |
| issn | 0148-396X 1524-4040 |
| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Aneurysm, Ruptured - diagnostic imaging Aneurysm, Ruptured - epidemiology Aneurysms Biological and medical sciences Cerebral Angiography Cerebrovascular Circulation Cohort Studies Databases, Factual - statistics & numerical data Humans Incidence Intracranial Aneurysm - diagnostic imaging Intracranial Aneurysm - epidemiology Medical sciences Neurosurgery Retrospective Studies Risk Assessment - methods Risk Factors Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases |
| title | Analysis of Nonmodifiable Risk Factors for Intracranial Aneurysm Rupture in a Large, Retrospective Cohort |
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