Risk of rupture of unruptured cerebral aneurysms in elderly patients

Tomohito Hishikawa, Isao Date, Koji Tokunaga, Shinjiro Tominari, Kazuhiko Nozaki, Yoshiaki Shiokawa, Kiyohiro Houkin, Yuichi Murayama, Toshihiro Ishibashi, Hiroyuki Takao, Toshikazu Kimura, Takeo Nakayama, Akio Morita

Research output: Contribution to journalArticle

15 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1879-1885
Number of pages7
JournalNeurology
Volume85
Issue number21
DOIs
Publication statusPublished - Nov 24 2015

Fingerprint

Intracranial Aneurysm
Rupture
Confidence Intervals
Aneurysm
Japan
Prospective Studies
Subarachnoid Hemorrhage
Cohort Studies
Medicine

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Hishikawa, T., Date, I., Tokunaga, K., Tominari, S., Nozaki, K., Shiokawa, Y., ... Morita, A. (2015). Risk of rupture of unruptured cerebral aneurysms in elderly patients. Neurology, 85(21), 1879-1885. https://doi.org/10.1212/WNL.0000000000002149

Risk of rupture of unruptured cerebral aneurysms in elderly patients. / Hishikawa, Tomohito; Date, Isao; Tokunaga, Koji; Tominari, Shinjiro; Nozaki, Kazuhiko; Shiokawa, Yoshiaki; Houkin, Kiyohiro; Murayama, Yuichi; Ishibashi, Toshihiro; Takao, Hiroyuki; Kimura, Toshikazu; Nakayama, Takeo; Morita, Akio.

In: Neurology, Vol. 85, No. 21, 24.11.2015, p. 1879-1885.

Research output: Contribution to journalArticle

Hishikawa, T, Date, I, Tokunaga, K, Tominari, S, Nozaki, K, Shiokawa, Y, Houkin, K, Murayama, Y, Ishibashi, T, Takao, H, Kimura, T, Nakayama, T & Morita, A 2015, 'Risk of rupture of unruptured cerebral aneurysms in elderly patients', Neurology, vol. 85, no. 21, pp. 1879-1885. https://doi.org/10.1212/WNL.0000000000002149
Hishikawa, Tomohito ; Date, Isao ; Tokunaga, Koji ; Tominari, Shinjiro ; Nozaki, Kazuhiko ; Shiokawa, Yoshiaki ; Houkin, Kiyohiro ; Murayama, Yuichi ; Ishibashi, Toshihiro ; Takao, Hiroyuki ; Kimura, Toshikazu ; Nakayama, Takeo ; Morita, Akio. / Risk of rupture of unruptured cerebral aneurysms in elderly patients. In: Neurology. 2015 ; Vol. 85, No. 21. pp. 1879-1885.
@article{088eed2ec52547ca92e6d0d0d8d66278,
title = "Risk of rupture of unruptured cerebral aneurysms in elderly patients",
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.",
author = "Tomohito Hishikawa and Isao Date and Koji Tokunaga and Shinjiro Tominari and Kazuhiko Nozaki and Yoshiaki Shiokawa and Kiyohiro Houkin and Yuichi Murayama and Toshihiro Ishibashi and Hiroyuki Takao and Toshikazu Kimura and Takeo Nakayama and Akio Morita",
year = "2015",
month = "11",
day = "24",
doi = "10.1212/WNL.0000000000002149",
language = "English",
volume = "85",
pages = "1879--1885",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "21",

}

TY - JOUR

T1 - Risk of rupture of unruptured cerebral aneurysms in elderly patients

AU - Hishikawa, Tomohito

AU - Date, Isao

AU - Tokunaga, Koji

AU - Tominari, Shinjiro

AU - Nozaki, Kazuhiko

AU - Shiokawa, Yoshiaki

AU - Houkin, Kiyohiro

AU - Murayama, Yuichi

AU - Ishibashi, Toshihiro

AU - Takao, Hiroyuki

AU - Kimura, Toshikazu

AU - Nakayama, Takeo

AU - Morita, Akio

PY - 2015/11/24

Y1 - 2015/11/24

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84947982831&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84947982831&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000002149

DO - 10.1212/WNL.0000000000002149

M3 - Article

C2 - 26511450

AN - SCOPUS:84947982831

VL - 85

SP - 1879

EP - 1885

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 21

ER -