Rupture Risk Factors Analysis Of Intracranial Aneurysms

Background:With the development of life living,the popularity of health knowledge and cerebral angiography examination technology,intracranial aneurysms were diagnosed and known more and more frequent.It contains ruptured aneurysms and unruptured aneurysms.Intracranial aneurysm rupture suddenly and is the leading cause of subarachnoid hemorrhage.Intracranial aneurysms also is the third cause of cerebrovascular accident.It is because of its high mortality and morbidity,early identify the high risk rupture of intracranial aneurysms of patients is very important.Domestic and foreign scholars have explored on the risk factors of the aneurysm rupture.The current research mainly about the living habits,basic diseases,characteristics of the aneurysm and hemodynamic study of intracranial aneurysms.yet in many clinical risk factors such as history of hypertension,smoking,drinking has not been reached an agreement.In the aspect of aneurysm characteristics,ruptured aneurysm size threshold,aneurysm morphology division standard have no common conclusion.Objective: To explore rupture related risk factors of intracranial aneurysms in order to provide useful information for decision-making for the treatment of unruptured aneurysms.Methods:The basic clinical information and aneurysm feature indicators are collected and retrospectively anaysed in patient diagnosed with intracranial aneurysms in the second hospital of Dalian Medical University from January 2008 to October2016.A total of 213 patients with 247 aneurysms were included.The basic clinical information icluded age,gender,smoking history,drinking history,hypertension history,diabetes history,hyperlipidemia,aspirin use history and family history.The aneurysmfeature indicators included aneurysm location,diameter,morphology,neck width and baby aneurysm.According to whether the aneurysm is ruptured,all the patients and aneurysms were divided into ruptured group and unruptured group.All the patients and aneurysms were self-control studied.First of all,using single factor those factors were analysed to select statistically significant risk factors with P < 0.05.Then those statistically significant risk factors were put into the multiariable Logistic regression analysis to find out the independent risk factors for intracranial aneurysms rupture.Results: 1.Single factor analysis results showed that history of hypertension(?~2=16.65,P < 0.01)is a risk factor for intracranial aneurysm rupture with significant difference statistically in two groups.But age,gender,smoking history,drinking history,diabetes history,hyperlipidemia,aspirin use history,family history were not the risk factor for intracranial aneurysms rupture.Aneurysm location(?~2= 30.86,P < 0.01),and the aneurysm diameter(?~2= 17.145,P < 0.01),morphology(?~2= 10.965,P =0.001),neck width(?~2= 4.948,P = 0.034)were the risk factors for intracranial aneurysm rupture.2.Multiple factors Logisitc regression analysis result showed: history of high blood pressure,the anterior communicating artery aneurysms,the posterior communicating artery aneurysms,with a 4 ~ 8 mm diameter aneurysm and irregular aneurysms were independent risk factors for intracranial aneurysms rupture.Conclusion: History of hypertension(OR=2.873,95%CI 1.563~5.282),the anterior communicating artery aneurysms(OR=3.891,95%CI 3.227~4.155),posterior communicating artery aneurysms(OR=6.667,95%CI 5.023~8.825),4 ~ 8 mm diameter size of aneurysm(OR=2.336,95%CI 1.439~9.364),irregular aneurysms(OR=2.500,95%CI 1.224~5.102)were independent risk factors for intracranial aneurysms rupture.