Article
Multiple intracranial aneurysms – the PHASES Scores applicability and accuracy in 275 patients harbouring 661 intracranial aneurysms
Multiple intrakranielle Aneurysmen – die Anwendung und Genauigkeit des PHASES Scores bei 275 Patienten mit insgesamt 661 intrakraniellen Aneurysmen
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Published: | June 4, 2021 |
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Objective: The subgroup of patients with multiple intracranial aneurysms (MIA) accounts for about 20% of all patients suffering from intracranial aneurysms (IA). There are controversial findings regarding a higher rupture risk in patients with MIA, leading to uncertainties in assessment of individual risk for aneurysm rupture. We performed a subgroup - evaluation of the PHASES Score with respect to its applicability on patients with MIA.
Methods: We analyzed 275 patients harboring a total number of 661 MIA regarding the accuracy of the PHASES Score for prediction of SAH using Receiver Operating Characteristics (ROC). Additionally, we analyzed the patients with aneurysmal subarachnoid hemorrhage (SAH) more closely.
Results: The PHASES Score achieved an area under the curve (AUC) of 0.57 in prediction of SAH in patients with MIA with corresponding sensitivity of 60% and specificity of 46%. We observed the following distribution of corresponding 5-year rupture risk in patients with aneurysmal SAH: <1% risk (40%), 1-1.9% risk (30%), 2-4.9% risk (19%) and >5% risk (11%).
Conclusion: The PHASES Score shows low sensitivity and specificity in prediction of aneurysm rupture in patients with MIA. Patients harboring MIA and suffering from a SAH seem to be categorized as patients with singular IA. The use of new specific analytical tool to predict the rupture risk in patients with MIA is mandatory.