Intracranial Aneurysm
Analysis of clinical risk factors for rupture of intracranial aneurysms
Huibin Kang, Aihua Liu, Youxiang Li, Chuhan Jiang, Zhongxue Wu, Hongbing Zhang
Published 2018-10-28
Cite as Chin J Neurosurg, 2018, 34(10): 1012-1016. DOI: 10.3760/cma.j.issn.1001-2346.2018.10.009
Abstract
ObjectiveTo explore the risk factors affecting the rupture of intracranial aneurysms (IA).
MethodsA retrospective analysis was conducted on 486 patients with IA admitted to Department of Neurological Intervention, Beijing Tiantan Hospital Affiliated to Capital Medical University and 95 IA patients admitted to Department of Neurosurgery of Beijing Luhe Hospital Affiliated to Capital Medical University from January to December of 2016. According to the presence/absence of rupture, those patients were divided into ruptured group (n=120) and unruptured group (n=461). Univariate analysis and multivariate logistic regression analysis were used to analyze the risk of IA rupture.
ResultsUnivariate and multivariate logistic regression analysis showed that hypertension (OR=1.778, 95% CI: 1.101-2.870, P=0.019) and the location of aneurysm (anterior communicating: OR=15.808, 95% CI: 7.284-34.309, P<0.001; posterior communicating: OR=11.437, 95% CI: 5.303-24.665, P<0.001), maximum diameter (OR=2.045, 95% CI: 1.144-3.657, P=0.016) and shape (OR=1.705, 95% CI: 1.030-2.825, P=0.038) are independent risk factors for IA rupture, while hyperlipidemia was a protective factor (OR=0.212, 95% CI: 0.073-0.615, P=0.004) and could reduce the risk of rupture of IA. The risk of rupture in patients with smoking <20/d and smoking ≥20/d was 3.290 and 3.460 times that of non-smokers, respectively, indicating that the risk of IA rupture was elevated with the increase of number of cigarettes smoked per day (P<0.05). There was no significant difference in the risk of aneurysm rupture between patients with smoking cessation and non-smokers (OR=0.654, 95% CI: 0.179-2.388, P=0.520).
ConclusionsSmoking is an independent risk factor for rupture of IA and smoking cessation does not increase the risk of rupture of IA. Hypertension, located at ACoA (anterior communicating artery) and PCoA (posterior communicating artery), aneurysm diameter of ≥7 mm and irregular shape could increase the rupture risk of IA while hyperlipidemia could reduce the risk of IA rupture.
Key words:
Intracranial aneurysm; Rupture, spontaneous; Risk factors; Smoking cessation
Contributor Information
Huibin Kang
Department of Neurosurgery, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing 101100, China
Aihua Liu
Youxiang Li
Chuhan Jiang
Zhongxue Wu
Hongbing Zhang
