gms | German Medical Science

66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Intracranial aneurysms are more frequent in smokers but do not have a higher rupture rate than in the non-smoking population. Analysis of the Aneurist data

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  • Bawarjan Schatlo - Department of Neurosurgery. University Hospital Geneva, Geneva, Switzerland; Department of Neurosurgery. University Hospital Göttingen, Germany
  • Oliver P. Gautschi - Department of Neurosurgery. University Hospital Geneva, Geneva, Switzerland
  • Christoph Friedrich - Fraunhofer-Institut SCAI, Dortmund, Germany
  • Veit Rohde - Department of Neurosurgery. University Hospital Göttingen, Germany
  • Karl Schaller - Department of Neurosurgery. University Hospital Geneva, Geneva, Switzerland
  • Philippe Bijlenga - Department of Neurosurgery. University Hospital Geneva, Geneva, Switzerland

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocMO.09.06

doi: 10.3205/15dgnc043, urn:nbn:de:0183-15dgnc0435

Published: June 2, 2015

© 2015 Schatlo et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: It is known that smoking is a risk factor for the presence of an intracranial aneurysm. Whether smoking increases the risk of rupture remains to be established. We assessed the role of smoking in a large European cohort of patients diagnosed with ruptured and unruptured intracranial aneurysms.

Method: We analyzed the information collected at aneurysm diagnosis for each patient recruited in the @neurIST project between Novembre 1st 2006 and March 31st 2012. Information about presence of SAH at diagnosis, gender and smoking were available for 975 aneurysm patients (676 female, 299 male). The prevalence of smokers in the general population was compared to the prevalence of smokers in the population of patients diagnosed with at least one intracranial aneurysm. Odd's ratios were calculated between different patient groups to assess the association of smoking with aneurysm formation and rupture.

Results: There is a higher proportion of smokers in patients with unruptured aneurysms (UA) and patients suffering a subarachnoid hemorrhage (SAH) compared to the general population (UA:OR 1.57, 95% CI: 1.28-1.92; SAH:OR 1.76, 95% CI: 1.48-2.09). Multiple aneurysms are more frequent in the population of smokers (non-smokers: 79/380; 21%); smokers: (160/574; 28%); OR 1.47, 95% CI: 1.08-2.00). Smokers with multiple aneurysms have a longer smoking history than smokers with single aneurysms (27.1 ± 11.6 versus 24.8 ± 12.43, p=0.047). The proportion of smokers suffering subarachnoid hemorrhage is similar to the proportion of non-smokers patients (OR 1.04, 95% CI: 0.89-1.21).

Conclusions: Smoking is an important modifiable risk factor for aneurysm formation. Single intracranial aneurysm and multiple aneurysms are more frequent in smokers. The relative risk of aneurysm rupture appears not to be affected by smoking. The observation may reflect a potentially different biological background of aneurysms in smokers and non-smokers.