Long-Term Hemorrhage Risk in Children Versus Adults With Brain Arteriovenous Malformations
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Discussion
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Implication
Cohort study reveals lower adjusted risk of subsequent intracranial hemorrhage in children with brain arteriovenous malformations, suggesting children do not face higher bleeding risks.
Key Points
- To compare the long-term risk of subsequent intracranial hemorrhage between children and adults diagnosed with brain arteriovenous malformations.
- Evaluated 1,219 patients with brain arteriovenous malformations from the University of California, San Francisco (n=400) and Kaiser Permanente Northern California (n=819).
- Followed patients across 996 person-years in the childhood cohort (<20 years old) and 3,260 person-years in the adult cohort, censoring at subsequent hemorrhage, first intervention, or loss to follow-up.
- Estimated hemorrhage rates using Kaplan-Meier survival curves and Cox proportional hazards models adjusted for initial hemorrhagic presentation and confounders.
- Unadjusted annual subsequent intracranial hemorrhage rates were 2.0% for children and 2.2% for adults (P=0.82 by log-rank test).
- Children presented significantly more often with an initial intracranial hemorrhage than adults (P<0.001).
- After multivariate adjustment for initial presentation, children had significantly lower subsequent hemorrhage rates than adults (hazard ratio, 0.10; 95% CI, 0.01 to 0.86; P=0.036).
Cite This Study
Fullerton et al. (2005) studied this question.