PHASES and ELAPSS score are associated with aneurysm growth: A study of 431 unruptured intracranial aneurysms.

PHASES and ELAPSS score are associated with aneurysm growth: A study of 431 unruptured intracranial aneurysms.

World Neurosurg. 2018 Mar 09;:

Authors: Brinjikji W, Pereira VM, Khumtong R, Kostensky A, Tymianski M, Krings T, Radovanovich I

Abstract
BACKGROUND AND PURPOSE: Understanding risk factors for intracranial aneurysm growth is important for patient management. We performed a retrospective study examining risk factors for growth of unruptured intracranial aneurysms followed at our institution examining both traditional risk factors and the PHASES score.
MATERIALS AND METHODS: We retrospectively reviewed a consecutive series of unruptured intracranial aneurysms followed at our institution for a minimum of six months over a 15-year period. The primary outcome of this study was aneurysm growth which was defined as a ≥1mm increase in maximum diameter. Risk factors studied included PHASES score, ELAPSE score demographics, multiple aneurysms, prior subarachnoid hemorrhage, family history of aneurysm or subarachnoid hemorrhage, smoking, hypertension, and aneurysm shape, size and location. Chi-squared tests were used for comparison of categorical variables and student's t-test for continuous variables.
RESULTS: 352 patients with 431 unruptured intracranial aneurysms were included. Mean follow-up was 4.8 years and there was a total of 2100 aneurysm-years of follow-up. A total of 40 aneurysms (9.3%) grew for an annualized growth rate of 2.0% of aneurysms/year. Current smoking status was the only modifiable risk factor associated with growth (growth rate of 5.1%/year compared to 1.5%/year for never smoker, P=0.0004). Increasing size (OR=1.22, 95%CI=1.11-1.33, P<.0001), ELAPSS score (OR=1.10, 95%CI=1.09-1.11, P<.0001), and PHASES score (OR=1.24, 95%CI=1.20-1.28, P<.0001) were associated with growth as well. Age, location, prior subarachnoid hemorrhage and hypertension were not independently associated with aneurysm growth.
CONCLUSIONS: Our retrospective study suggests that aneurysm size, smoking status, PHASES score and ELAPSS score are associated with aneurysm growth.

PMID: 29530704 [PubMed - as supplied by publisher]

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