Risk of rupture of unruptured cerebral aneurysms in elderly patients

Risk of rupture of unruptured cerebral aneurysms in elderly patients

  1. Tomohito Hishikawa, MD,
  2. Isao Date, MD,
  3. Koji Tokunaga, MD,
  4. Shinjiro Tominari, MD, MPH,
  5. Kazuhiko Nozaki, MD, PhD,
  6. Yoshiaki Shiokawa, MD, PhD,
  7. Kiyohiro Houkin, MD, PhD,
  8. Yuichi Murayama, MD,
  9. Toshihiro Ishibashi, MD,
  10. Hiroyuki Takao, MD,
  11. Toshikazu Kimura, MD,
  12. Takeo Nakayama, MD, PhD,
  13. Akio Morita, MD, PhD;
  14. For UCAS Japan and UCAS II Investigators
  1. Neurology November 24, 2015 vol. 85 no. 21 1879-1885

ABSTRACT

Objectives: The aim of this study was to identify risk factors for rupture of unruptured cerebral aneurysms (UCAs) in elderly Japanese patients aged 70 years or older.

Methods: The participants included all patients 70 years of age or older in 3 prospective studies in Japan (the Unruptured Cerebral Aneurysm Study of Japan [UCAS Japan], UCAS II, and the prospective study at the Jikei University School of Medicine). A total of 1,896 patients aged 70 years or older with 2,227 UCAs were investigated. The median and mean follow-up periods were 990 and 802.7 days, respectively.

Results: The mean aneurysm size was 6.2 ± 3.9 mm. Sixty-eight patients (3.6%) experienced subarachnoid hemorrhage during the follow-up period. Multivariable analysis per patient revealed that in patients aged 80 years or older (hazard ratio [HR], 2.02; 95% confidence interval [CI], 1.16–3.49, p = 0.012), aneurysms 7 mm or larger (HR, 3.08; 95% CI, 1.35–7.03, p = 0.007 for 7–9 mm; HR, 7.82; 95% CI, 3.60–16.98, p < 0.001 for 10–24 mm; and HR, 43.31; 95% CI, 12.55–149.42, p < 0.001 for ≥25 mm) and internal carotid–posterior communicating artery aneurysms (HR, 2.45; 95% CI, 1.23–4.88, p = 0.011) were independent predictors for UCA rupture in elderly patients.

Conclusions: In our pooled analysis of prospective cohorts in Japan, patient age and aneurysm size and location were significant risk factors for UCA rupture in elderly patients.

READ MORE: http://www.neurology.org/content/85/21/1879.full

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