ELAPSS score for prediction of risk of growth of unruptured intracranial aneurysms. (25th April 2017)

• Record Type: Journal Article
• Authors: Backes, Daan; Rinkel, Gabriel J.E.; Greving, Jacoba P.; Velthuis, Birgitta K.; Murayama, Yuichi; Takao, Hiroyuki; Ishibashi, Toshihiro; Igase, Michiya; terBrugge, Karel G.; Agid, Ronit; Jääskeläinen, Juha E.; Lindgren, Antti E.; Koivisto, Timo; von und zu Fraunberg, Mikael; Matsubara, Shunji; Moroi, Junta; Wong, George K.C.; Abrigo, Jill M.; Igase, Keiji; Matsumoto, Katsumi; Wermer, Marieke J.H.; van Walderveen, Marianne A.A.; Algra, Ale; Vergouwen, Mervyn D.I.
• Is Part Of: Neurology. Volume 88:Number 17(2017)
• Publication Date: 2017-04-25
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000003865
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : Objective: To develop a risk score that estimates 3-year and 5-year absolute risks for aneurysm growth. Methods: From 10 cohorts of patients with unruptured intracranial aneurysms and follow-up imaging, we pooled individual data on sex, population, age, hypertension, history of subarachnoid hemorrhage, and aneurysm location, size, aspect ratio, and shape but not on smoking during follow-up and family history of intracranial aneurysms in 1, 507 patients with 1, 909 unruptured intracranial aneurysms and used aneurysm growth as outcome. With aneurysm-based multivariable Cox regression analysis, we determined predictors for aneurysm growth, which were presented as a risk score to calculate 3-year and 5-year risks for aneurysm growth by risk factor status. Results: Aneurysm growth occurred in 257 patients (17%) and 267 aneurysms (14%) during 5, 782 patient-years of follow-up. Predictors for aneurysm growth were earlier subarachnoid hemorrhage, location of the aneurysm, age >60 years, population, size of the aneurysm, and shape of the aneurysm (ELAPSS). The 3-year growth risk ranged from <5% to >42% and the 5-year growth risk from <9% to >60%, depending on the risk factor status. Conclusions: The ELAPSS score consists of 6 easily retrievable predictors and can help physicians in decision making on the need for and timing of follow-up imaging in patients with unruptured intracranial aneurysms.