Abdominal Aortic Aneurysm is an Independent Risk Factor for Subarachnoid Hemorrhage. (1st September 2019)

• Record Type: Journal Article
• Authors: Wilkinson, D Andrew; Nadel, Jeffrey L; Chaudhary, Neeraj; Gemmete, Joseph J; Thompson, Byron G; Pandey, Aditya S
• Is Part Of: Neurosurgery. Volume 66(2010)Supplement 1
• Publication Date: 2019-09-01
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyz310_674
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: Though both diseases share similar risk factors, little is known about the relationship between intracranial aneurysms (IA) and abdominal aortic aneurysms (AAA). Previous studies have described an increased incidence of IA in patients with AAA, though the rate of subarachnoid hemorrhage (SAH) in patients with AAA has not been described. This study evaluated the rate of SAH in patients with known AAA. METHODS: We examined longitudinally linked medical claims data from a large private insurer, finding rates aneurysmal subarachnoid hemorrhage (aSAH) and secured aneurysmal SAH (saSAH) in 2004 to 2014 among patients with previously diagnosed AAA. RESULTS: We identified 62 910 patients with a diagnosis of AAA with a total of 193 009 yr of at risk coverage, and compared them to age- and sex-matched controls matched 5:1. Both populations were predominantly male (70.9%) with an average age of 70.8. Rates of hypertension (69.7% vs 50.6%, P < .0001) and smoking (12.8% vs 4.1%, P < .0001) were higher in the AAA group compared to controls. A total of 50 admissions for aSAH were identified in AAA patients (26/100K patient years, 95% CI 19-44) and 115 admissions for aSAH in controls (7/100K patient years, 95% CI 6-9), giving an incidence rate ratio (IRR) of 3.6 (95% CI 2.6-5.0, P < .0001) and a comorbidity-adjusted IRR of 2.8 (95% CI 1.9-3.9) for AAA patients. The incidence of saSAH was proportionally even higher in AAA patients than controls, 7 vs 2/100K patient years, IRR 4.5 (95% CI 3.2-6.3, P < .0001). CONCLUSION: The rate of SAH is elevated in patients with AAA compared with age- and sex-matched controls, even after adjustment for comorbidities. Use of AAA in screening criteria for IA should be considered.