Shinjiro Tominari1, Akio Morita2,3, Toshihiro Ishibashi4, Tomosato Yamazaki5, Hiroyuki Takao4, Yuichi Murayama4, Makoto Sonobe5, Masahiro Yonekura6, Nobuhito Saito7, Yoshiaki Shiokawa8, Isao Date9, Teiji Tominaga10, Kazuhiko Nozaki11, Kiyohiro Houkin12, Susumu Miyamoto13, Takaaki Kirino14, Kazuo Hashi15, Takeo Nakayama1. 1. Department of Health Informatics, Kyoto University School of Public Health, Kyoto. 2. Unruptured Cerebral Aneurysm Study Japan Coordinating Office, University of Tokyo, Tokyo. 3. Department of Neurological Surgery, Nippon Medical School, Tokyo. 4. Division of Endovascular Neurosurgery, Department of Neurosurgery, Jikei University School of Medicine, Tokyo. 5. Department of Neurosurgery, National Hospital Organization, Mito Medical Center, Ibaraki. 6. Department of Neurosurgery, National Hospital Organization, Nagasaki Medical Center, Nagasaki. 7. Department of Neurosurgery, University of Tokyo, Tokyo. 8. Department of Neurosurgery, Kyorin University School of Medicine, Tokyo. 9. Department of Neurological Surgery, Okayama University Graduate School of Medicine, Okayama. 10. Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai. 11. Department of Neurosurgery, Shiga University of Medical Science, Otsu. 12. Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo. 13. Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto. 14. National Hospital Organization, Tokyo. 15. Shinsapporo Neurosurgical Hospital, Sapporo, Japan.
Abstract
OBJECTIVE: To build a prediction model that estimates the 3-year rupture risk of unruptured saccular cerebral aneurysms. METHODS: Survival analysis was done using each aneurysm as the unit for analysis. Derivation data were from the Unruptured Cerebral Aneurysm Study (UCAS) in Japan. It consists of patients with unruptured cerebral aneurysms enrolled between 2000 and 2004 at neurosurgical departments at tertiary care hospitals in Japan. The model was presented as a scoring system, and aneurysms were classified into 4 risk grades by predicted 3-year rupture risk: I, < 1%; II, 1 to 3%; III, 3 to 9%, and IV, >9%. The discrimination property and calibration plot of the model were evaluated with external validation data. They were a combination of 3 Japanese cohort studies: UCAS II, the Small Unruptured Intracranial Aneurysm Verification study, and the study at Jikei University School of Medicine. RESULTS: The derivation data include 6,606 unruptured cerebral aneurysms in 5,651 patients. During the 11,482 aneurysm-year follow-up period, 107 ruptures were observed. The predictors chosen for the scoring system were patient age, sex, and hypertension, along with aneurysm size, location, and the presence of a daughter sac. The 3-year risk of rupture ranged from <1% to >15% depending on the individual characteristics of patients and aneurysms. External validation indicated good discrimination and calibration properties. INTERPRETATION: A simple scoring system that only needs easily available patient and aneurysmal information was constructed. This can be used in clinical decision making regarding management of unruptured cerebral aneurysms.
OBJECTIVE: To build a prediction model that estimates the 3-year rupture risk of unruptured saccular cerebral aneurysms. METHODS: Survival analysis was done using each aneurysm as the unit for analysis. Derivation data were from the Unruptured Cerebral Aneurysm Study (UCAS) in Japan. It consists of patients with unruptured cerebral aneurysms enrolled between 2000 and 2004 at neurosurgical departments at tertiary care hospitals in Japan. The model was presented as a scoring system, and aneurysms were classified into 4 risk grades by predicted 3-year rupture risk: I, < 1%; II, 1 to 3%; III, 3 to 9%, and IV, >9%. The discrimination property and calibration plot of the model were evaluated with external validation data. They were a combination of 3 Japanese cohort studies: UCAS II, the Small Unruptured Intracranial Aneurysm Verification study, and the study at Jikei University School of Medicine. RESULTS: The derivation data include 6,606 unruptured cerebral aneurysms in 5,651 patients. During the 11,482 aneurysm-year follow-up period, 107 ruptures were observed. The predictors chosen for the scoring system were patient age, sex, and hypertension, along with aneurysm size, location, and the presence of a daughter sac. The 3-year risk of rupture ranged from <1% to >15% depending on the individual characteristics of patients and aneurysms. External validation indicated good discrimination and calibration properties. INTERPRETATION: A simple scoring system that only needs easily available patient and aneurysmal information was constructed. This can be used in clinical decision making regarding management of unruptured cerebral aneurysms.
Authors: Felicitas J Detmer; Bong Jae Chung; Fernando Mut; Martin Slawski; Farid Hamzei-Sichani; Christopher Putman; Carlos Jiménez; Juan R Cebral Journal: Int J Comput Assist Radiol Surg Date: 2018-08-09 Impact factor: 2.924
Authors: Felicitas J Detmer; Daniel Lückehe; Fernando Mut; Martin Slawski; Sven Hirsch; Philippe Bijlenga; Gabriele von Voigt; Juan R Cebral Journal: Int J Comput Assist Radiol Surg Date: 2019-09-04 Impact factor: 2.924
Authors: Felicitas J Detmer; Bong Jae Chung; Fernando Mut; Michael Pritz; Martin Slawski; Farid Hamzei-Sichani; David Kallmes; Christopher Putman; Carlos Jimenez; Juan R Cebral Journal: Acta Neurochir (Wien) Date: 2018-06-20 Impact factor: 2.216
Authors: Philippe Bijlenga; Akio Morita; Nerissa U Ko; J Mocco; Sandrine Morel; Yuichi Murayama; Marieke J H Wermer; Robert D Brown Journal: Neurocrit Care Date: 2019-06 Impact factor: 3.210