Development of the SAFETEA Scores for Predicting Risks of Complications of Preventive Endovascular or Microneurosurgical Intracranial Aneurysm Occlusion

Autor: Annemijn M. Algra, Jacoba P. Greving, Jordi de Winkel, Arttu Kurtelius, Kamil Laban, Dagmar Verbaan, René van den Berg, William Vandertop, Antti Lindgren, Timo Krings, Peter Yat Ming Woo, George Kwok Chu Wong, Bob Roozenbeek, Adriaan C.G.M. van Es, Ruben Dammers, Nima Etminan, Hieronymus Boogaarts, Tristan van Doormaal, Albert van der Zwan, Irene C. van der Schaaf, Gabriël J.E. Rinkel, Mervyn D.I. Vergouwen
Přispěvatelé: Neurosurgery, Amsterdam Neuroscience - Neurovascular Disorders, Radiology and Nuclear Medicine, ACS - Microcirculation, Amsterdam Neuroscience - Systems & Network Neuroscience, Radiology and nuclear medicine, CCA - Imaging and biomarkers, Neurology, Radiology & Nuclear Medicine
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Algra, A M, Greving, J P, de Winkel, J, Kurtelius, A, Laban, K, Verbaan, D, van den Berg, R, Vandertop, W, Lindgren, A, Krings, T, Woo, P Y M, Wong, G K C, Roozenbeek, B, van Es, A C G M, Dammers, R, Etminan, N, Boogaarts, H, van Doormaal, T, van der Zwan, A, van der Schaaf, I C, Rinkel, G J E & Vergouwen, M D I 2022, ' Development of the SAFETEA Scores for Predicting Risks of Complications of Preventive Endovascular or Microneurosurgical Intracranial Aneurysm Occlusion ', Neurology, vol. 99, no. 16, pp. E1725-E1737 . https://doi.org/10.1212/WNL.0000000000200978
Neurology, 99(16), E1725-E1737. Lippincott Williams and Wilkins
Neurology, 99(16), E1725-E1737. Lippincott Williams & Wilkins
ISSN: 0028-3878
Popis: Objective:Preventive unruptured intracranial aneurysm occlusion can reduce the risk of subarachnoid hemorrhage, but both endovascular and microneurosurgical treatment carry a risk of serious complications. To improve individualized management decisions, we developed risk scores for complications of endovascular and microneurosurgical treatment based on easily retrievable patient, aneurysm, and treatment characteristics.Methods:For this multicenter cohort study, we combined individual patient data from unruptured intracranial aneurysm patients ≥18 years undergoing preventive endovascular treatment (standard, balloon-assisted or stent-assisted coiling, Woven EndoBridge-device, or flow-diverting stent) or microneurosurgical clipping at one of 10 participating centers from three continents between 2000-2018. The primary outcome was death from any cause or clinical deterioration from neurological complications ≤30 days. We selected predictors based on previous knowledge about relevant risk factors and predictor performance and studied the association between predictors and complications with logistic regression. We assessed model performance with calibration plots and concordance (c) statistics.Results:Of 1282 included patients, 94 (7.3%) had neurological symptoms that resolved c-statistic was 0.72 (95%CI:0.67-0.77) and the absolute complication risk ranged from 3.2% (95%CI:1.6%-14.9%;≤1 point) to 33.1% (95%CI:25.4%-41.5%;≥6 points). For microneurosurgical treatment (n=530), the c-statistic was 0.72 (95%CI:0.67-0.77) and the complication risk ranged from 4.9% (95%CI:1.5%-14.9%;≤1 point) to 49.9% (95%CI:39.4%-60.6%;≥6 points).Conclusions:The SAFETEA risk scores for endovascular and microneurosurgical treatment are based on seven easily retrievable risk factors to predict the absolute risk of procedural complications in patients with unruptured intracranial aneurysms. The scores need external validation before the predicted risks can be properly used to support decision making in clinical practice.
Databáze: OpenAIRE
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