Artikel
The application of the unruptured intracranial aneurysm treatment score – a retrospective, single-center analysis
Suche in Medline nach
Autoren
-
Silvia Hernandez Duran
- Universitätsmedizin Göttingen, Klinik für Neurochirurgie, Göttingen, Deutschland
-
Vesna Malinova
- Universitätsmedizin Göttingen, Klinik und Poliklinik für Neurochirurgie, Göttingen, Deutschland
-
Dorothee Mielke
- Universitätsmedizin Göttingen, Klinik und Poliklinik für Neurochirurgie, Göttingen, Deutschland
-
Veit Rohde
- Universitätsmedizin Göttingen, Klinik und Poliklinik für Neurochirurgie, Göttingen, Deutschland
| Veröffentlicht: | 9. Juni 2017 |
|---|
Gliederung
Text
Objective: The unruptured intracranial aneurysm treatment score (UIATS) was published in April 2015 as a multidisciplinary consensus among cerebrovascular specialists regarding treatment of incidental intracranial aneurysms (IIA). The UIATS is based on the stratification of aneurysm-related, treatment-related, and patient-related risk factors. It should alleviate decision-making as to whether or not an IIA should be treated. As a tertiary center with focus on vascular neurosurgery, we aimed to investigate whether our decision-making in patients with IIA has been in accordance with the newly-published UIATS data.
Methods: We conducted a retrospective analysis of patients admitted to our center IIA from January 2011 to May 2016. The UIATS was applied to all IIA, and they were subsequently divided into three groups: (a) UIATS favoring treatment, (b) UIATS favoring observation, and (c) UIATS non-conclusive. The results of the UIATS were then compared to the clinical decisions made in these patients, and Spearman’s rank-order correlation was run to determine the relationship between the UIATS and our clinical decisions. Discrepancies between the UIATS and the clinical decisions made were then examined for associated complications, defined as intra-operative or post-operative complications in cases where UIATS favored observation. Statistical analysis was performed using IBM® SPSS® Statistics Version 21.
Results: A total of 93 patients, 65 (70%) females and 28 (30%) males, harboring 147 IIA were included. Mean age was 57 years (36-84). In our cohort, 118/147 (80.3%) of IIA were treated. In 70/118 (59.3%) of treated IIA, the UIATS favored treatment. In 18/118 (15.3%), the UIATS was non-conclusive, while in 30/118 (25.4%), the UIATS favored observation. In 29/147 (19.7%), IIA were not treated. In 15/29 (51.7%), the UIATS favored observation, while in 9/29 (31%) the UIATS favored treatment. In 5/29 (17.2%) the UIATS was non-conclusive. Spearman’s rank-order correlation coefficient was 0.366, p<0.01. Discrepancies between UIATS and our clinical decisions did not correlate with complications (correlation coefficient 0.034, p=0.714).
Conclusion: Our analysis shows that our clinical decision-making has been in line with the newly-established UIATS. Furthermore, it supports the use of the UIATS in clinical decision-making when treating unruptured intracranial aneurysms.
