Intracranial Aneurysm Classifier Using Phenotypic Factors: An International Pooled Analysis

Author:

Morel SandrineORCID,Hostettler Isabel C.ORCID,Spinner Georg R.,Bourcier Romain,Pera JoannaORCID,Meling Torstein R.ORCID,Alg Varinder S.,Houlden Henry,Bakker Mark K.ORCID,van’t Hof Femke,Rinkel Gabriel J. E.,Foroud Tatiana,Lai DongbingORCID,Moomaw Charles J.,Worrall Bradford B.,Caroff Jildaz,Constant-dits-Beaufils Pacôme,Karakachoff Matilde,Rimbert Antoine,Rouchaud Aymeric,Gaal-Paavola Emilia I.,Kaukovalta Hanna,Kivisaari Riku,Laakso Aki,Jahromi Behnam RezaiORCID,Tulamo Riikka,Friedrich Christoph M.ORCID,Dauvillier Jerome,Hirsch SvenORCID,Isidor Nathalie,Kulcsàr Zolt,Lövblad Karl O.,Martin Olivier,Machi Paolo,Mendes Pereira Vitor,Rüfenacht Daniel,Schaller Karl,Schilling Sabine,Slowik Agnieszka,Jaaskelainen Juha E.,von und zu Fraunberg Mikael,Jiménez-Conde Jordi,Cuadrado-Godia ElisaORCID,Soriano-Tárraga Carolina,Millwood Iona Y.,Walters Robin G.,Kim Helen,Redon Richard,Ko Nerissa U.,Rouleau Guy A.,Lindgren Antti,Niemelä Mika,Desal Hubert,Woo Daniel,Broderick Joseph P.,Werring David J.,Ruigrok Ynte M.,Bijlenga PhilippeORCID, , , ,

Abstract

Intracranial aneurysms (IAs) are usually asymptomatic with a low risk of rupture, but consequences of aneurysmal subarachnoid hemorrhage (aSAH) are severe. Identifying IAs at risk of rupture has important clinical and socio-economic consequences. The goal of this study was to assess the effect of patient and IA characteristics on the likelihood of IA being diagnosed incidentally versus ruptured. Patients were recruited at 21 international centers. Seven phenotypic patient characteristics and three IA characteristics were recorded. The analyzed cohort included 7992 patients. Multivariate analysis demonstrated that: (1) IA location is the strongest factor associated with IA rupture status at diagnosis; (2) Risk factor awareness (hypertension, smoking) increases the likelihood of being diagnosed with unruptured IA; (3) Patients with ruptured IAs in high-risk locations tend to be older, and their IAs are smaller; (4) Smokers with ruptured IAs tend to be younger, and their IAs are larger; (5) Female patients with ruptured IAs tend to be older, and their IAs are smaller; (6) IA size and age at rupture correlate. The assessment of associations regarding patient and IA characteristics with IA rupture allows us to refine IA disease models and provide data to develop risk instruments for clinicians to support personalized decision-making.

Funder

European Commission

Swiss SystemsX.ch initiative

Agence Nationale de la Recherche

Canadian Institutes of Health Research

Publisher

MDPI AG

Subject

Medicine (miscellaneous)

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