ELAPSS score for prediction of risk of growth of unruptured intracranial aneurysms

Daan Backes*, Gabriel J.E. Rinkel, Jacoba P. Greving, Birgitta K. Velthuis, Yuichi Murayama, Hiroyuki Takao, Toshihiro Ishibashi, Michiya Igase, Karel G. terBrugge, Ronit Agid, Juha E Jääskeläinen, Antti E. Lindgren, Timo Koivisto, Mikael von Und Zu Fraunberg, Shunji Matsubara, Junta Moroi, George K C Wong, Jill M Abrigo, Keiji Igase, Katsumi MatsumotoMarieke J H Wermer, Marianne A A van Walderveen, Ale Algra, Mervyn D.I. Vergouwen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1600-1606
Number of pages7
JournalNeurology
Volume88
Issue number17
DOIs
Publication statusPublished - 25 Apr 2017

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