Risk factors for ruptured intracranial aneurysms:a retrospective case series study
10.3760/cma.j.issn.1673-4165.2012.08.005
- VernacularTitle:颅内动脉瘤破裂的危险因素:回顾性病例系列研究
- Author:
Yansheng GAO
;
Laijun SONG
- Publication Type:Journal Article
- Keywords:
Intracranial Aneurysm;
Aneurysm,Ruptured;
Subarachnoid Hemorrhage;
Risk Factors
- From:
International Journal of Cerebrovascular Diseases
2012;20(8):579-582
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors for ruptured intracranial aneurysms in order to provide the basis for the clinical decision-making of intracranial aneurysms.Methods The demographic and clinical data of the patients with intracranial aneurysm were collected retrospectively.Three-dimensional cerebral angiography was used to identify the aneurismal location and shape,existing ascus or not,aneurysm length,maximum diameter and neck width.The aspect ratio (AR) of aneurysm was calculated.Results A total of 243 patients with intracranial aneurysms (289 aneurysms) were included,149 patients(171 aneurysms) in the ruptured aneurysm group,94 patients (118 aneurysms) in the unruptured aneurysm group.The proportions of female (71.1％ vs.51.1％ ;x2 =12.13,P ＜ 0.01),hypertension (57.7％ vs.38.3％ ;x2 =8.69,P =0.003),smoking (53.0％ vs.39.5％ ; x2 =4.12,P =0.045),existing ascus (63.7％ vs.39.8％ ; x2 =16.07,P ＜0.01),and the maximum diameter ＞ 5 mm (80.7％ vs.66.9％ ;x2 =7.06,P ＜ 0.01) in the ruptured aneurysm group were significantly higher than those in the unruptured aneurysm group,while the proportion of the maximum diameter ＞ 10 mm (31.6％vs.52.5％ ;x2 =12.77,P ＜0.01) was significantly lower than that in the unruptured aneurysm group; the maximum diameter in the ruptured aneurysm group was less than that in the unruptured aneurysm group (8.68± 5.79 mm vs.10.67± 5.78 mm; t=-2.91,P=0.004),while the aneurysm length (8.27 ± 4.19 mm vs.6.94 ± 4.77 mm; t =2.50,P =0.013) and AR (2.32 ± 1.18 vs.1.42± 1.21; t =634,P ＜ 0.01) were significantly longer and higher than that in the unruptured aneurysm group,respectively.Of the 289 aneurysms,103 were anterior communicating artery aneurysms,84 were posterior communicating artery aneurysms,56 were middle cerebral artery aneurysms,12 were anterior cerebral artery aneurysms,9 were internal carotid artery aneurysms,and 25 were basilar artery aneurysms.There were significant differences in the rupture incidence of intracranial aneurysm at different locations (63.1％,79.8％,41.1％,33.3％,33.3％,and 36.0％,respectively; P ＜0.01).Multivariate logistic regression analysis showed that the female (odds ratio [OR],6.311,95％ confidence interval [OR]3.673-10.844; P ＜ 0.01),existing ascus (OR 2.789,95％ CI 1.624-4.792; P＜0.01),and maximum diameter ＞5 mm (OR 1.866,95％ CI 1.012-3.437; P =0.046) were the independent risk factors for ruptured intracranial aneurysms.Conclusions The incidence and rupture rate in women patients with intracranial aneurysm were higher than those in men.Hypertension,history of smoking existing ascus,aneurysm location,aneurysm maximum diameter,aneurysm length and AR were all the factors that impact ruptured intracranial aneurysms,in which women,existing ascus and the maximum diameter ＞5 mm were the independent risk factors.
