External Validation of the ELAPSS Score for Prediction of Unruptured Intracranial Aneurysm Growth Risk.

Autor:	Sánchez van Kammen M; Department of Neurology and Neurosurgery, University Medical Centre Utrecht, Utrecht, the Netherlands., Greving JP; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands., Kuroda S; Department of Neurosurgery, University of Toyama, Toyama, Japan., Kashiwazaki D; Department of Neurosurgery, University of Toyama, Toyama, Japan., Morita A; Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan., Shiokawa Y; Department of Neurosurgery, Kyorin University, Tokyo, Japan., Kimura T; Department of Neurosurgery, NTT Medical Center Tokyo, Tokyo, Japan., Cognard C; Department of Neuroradiology, Toulouse University Hospital, Toulouse, France., Januel AC; Department of Neuroradiology, Toulouse University Hospital, Toulouse, France., Lindgren A; Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland., Koivisto T; Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland., Jääskeläinen JE; Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland.; Institute of Clinical Medicine-Neurosurgery, University of Eastern Finland, Kuopio, Finland., Ronkainen A; Department of Neurosurgery, University of Tampere, Tampere, Finland., Pyysalo L; Department of Neurosurgery, University of Tampere, Tampere, Finland., Öhman J; Department of Neurosurgery, University of Tampere, Tampere, Finland., Rahi M; Department of Neurosurgery, University of Turku, Turku, Finland., Kuhmonen J; Department of Neurosurgery, University of Turku, Turku, Finland., Rinne J; Department of Neurosurgery, University of Turku, Turku, Finland., Leemans EL; Department of Neuroradiology, Academic Medical Center, Amsterdam, the Netherlands.; Department of Biomedical Engineering and Physics,Academic Medical Center, Amsterdam, the Netherlands., Majoie CB; Department of Neuroradiology, Academic Medical Center, Amsterdam, the Netherlands., Vandertop WP; Department of Neurosurgery, Academic Medical Center, Amsterdam, the Netherlands., Verbaan D; Department of Neurosurgery, Academic Medical Center, Amsterdam, the Netherlands., Roos YBWEM; Department of Neurology, Academic Medical Center, Amsterdam, the Netherlands., Berg RVD; Department of Neuroradiology, Academic Medical Center, Amsterdam, the Netherlands., Boogaarts HD; Department of Neurosurgery, Radboud University Medical Center, Nijmegen, the Netherlands., Moudrous W; Department of Neurosurgery, Radboud University Medical Center, Nijmegen, the Netherlands., Wijngaard IRVD; Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.; Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands., Hove LT; Department of Radiology, Haaglanden Medical Center, Den Haag, the Netherlands., Teo M; Department of Neurosurgery, Institute of Neurological Science, Glasgow, UK., George EJS; Department of Neurosurgery, Institute of Neurological Science, Glasgow, UK., Hackenberg KAM; Department of Neurosurgery, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany., Abdulazim A; Department of Neurosurgery, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany., Etminan N; Department of Neurosurgery, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany., Rinkel GJE; Department of Neurology and Neurosurgery, University Medical Centre Utrecht, Utrecht, the Netherlands., Vergouwen MDI; Department of Neurology and Neurosurgery, University Medical Centre Utrecht, Utrecht, the Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of stroke [J Stroke] 2019 Sep; Vol. 21 (3), pp. 340-346. Date of Electronic Publication: 2019 Sep 30.
DOI:	10.5853/jos.2019.01277
Abstrakt:	Background and Purpose: Prediction of intracranial aneurysm growth risk can assist physicians in planning of follow-up imaging of conservatively managed unruptured intracranial aneurysms. We therefore aimed to externally validate the ELAPSS (Earlier subarachnoid hemorrhage, aneurysm Location, Age, Population, aneurysm Size and Shape) score for prediction of the risk of unruptured intracranial aneurysm growth. Methods: From 11 international cohorts of patients ≥18 years with ≥1 unruptured intracranial aneurysm and ≥6 months of radiological follow-up, we collected data on the predictors of the ELAPSS score, and calculated 3- and 5-year absolute growth risks according to the score. Model performance was assessed in terms of calibration (predicted versus observed risk) and discrimination (c-statistic). Results: We included 1,072 patients with a total of 1,452 aneurysms. During 4,268 aneurysm-years of follow-up, 199 (14%) aneurysms enlarged. Calibration was comparable to that of the development cohort with the overall observed risks within the range of the expected risks. The c-statistic was 0.69 (95% confidence interval [CI], 0.64 to 0.73) at 3 years, compared to 0.72 (95% CI, 0.68 to 0.76) in the development cohort. At 5 years, the c-statistic was 0.68 (95% CI, 0.64 to 0.72), compared to 0.72 (95% CI, 0.68 to 0.75) in the development cohort. Conclusion: s The ELAPSS score showed accurate calibration for 3- and 5-year risks of aneurysm growth and modest discrimination in our external validation cohort. This indicates that the score is externally valid and could assist patients and physicians in predicting growth of unruptured intracranial aneurysms and plan follow-up imaging accordingly.
Databáze:	MEDLINE
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