Key result
An inflow angle of < 90 degrees was independently associated with a higher Hunt and Hess grade (OR 3.881) and a higher Fisher grade in patients with ruptured small intracranial aneurysms.
Why the study?
The study was conducted to identify risk factors for clinical and radiographic grades of subarachnoid haemorrhage in small (< 5 mm) intracranial aneurysms.
Observational (n=160)
No
Inflow angle < 90 degrees, size ratio, aspirin use, previous SAH, and alcohol use are significant predictors of poorer clinical or radiological grades in ruptured small intracranial aneurysms.
AIM: To identify the risk factors for clinical and radiographic grades of subarachnoid haemorrhage (SAH) in small (< 5 mm) intracranial aneurysms (SIAs). MATERIAL AND METHODS: We retrospectively analysed patients with SIAs treated in our centre between February 2009 and June 2018. The clinical status was graded using the Hunt and Hess (H&H) score and the radiological severity of SAH was graded by Fisher grades (FG). The risk factors were determined using multivariate logistic regression analysis. RESULTS: A total of 160 patients with ruptured SIAs (< 5 mm) were included. In univariate analysis, smoking (P = 0.007), alcohol use (P = 0.048), aspirin use (P = 0.001), and higher size ratio (SR) (P = 0.001) were significantly associated with a higher H&H grade (3-5) in SIAs; and smoking (P = 0.019), aspirin use (P = 0.031), inflow angle < 90 degrees (P = 0.011), and aneurysm size (P = 0.039) were significantly associated with a higher FG score (3-4). In the adjusted multivariate analysis, previous SAH (OR, 12.245, 95% CI, 2.261-66.334, P = 0.004), aspirin use (OR, 4.677, 95% CI, 1.392-15.718, P = 0.013), alcohol use (OR, 3.392, 95% CI, 1.146-10.045, P = 0.027), inflow angle < 90 (OR, 3.881, 95% CI, 1.273-11.831, P = 0.017), and higher SR (OR, 6.611, 95% CI, 2.235-19.560, P = 0.001) were independent risk factors for a higher H&H grade in ruptured SIAs; smoking (OR, 2.157, 95% CI, 1.061-4.384, P = 0.034), and inflow angle < 90 degrees (OR, 2.603, 95% CI, 1.324-5.115, P = 0.006) were independent risk factors for a higher FG (3-4). CONCLUSIONS: This study revealed that inflow angle < 90 degrees and size ratio, but not absolute size, may highly predict poorer grade of SAH in SRA. Aspirin use, previous SAH, and alcohol use were significantly associated with a higher H&H grade in ruptured SIAs, and smoking was a significant predictor of poorer FG.
No takes yet. Share an insight, caveat, or question.
Tai et al. (2019) conducted an observational in Ruptured small intracranial aneurysms (< 5 mm) (n=160). Inflow angle < 90 degrees vs. Inflow angle ≥ 90 degrees was evaluated on Higher Hunt and Hess (H&H) grade (3-5) (OR 3.881, 95% CI 1.273-11.831, p=0.017). An inflow angle of < 90 degrees was independently associated with a higher Hunt and Hess grade (OR 3.881) and a higher Fisher grade in patients with ruptured small intracranial aneurysms.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: