Department of Medicine, The University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Int J Stroke. 2013 Dec;8(8):696-700. doi: 10.1111/j.1747-4949.2012.00857.x. Epub 2012 Aug 29.
Higher mortality for patients with aneurysmal subarachnoid haemorrhage has been reported.
In families with intracranial aneurysms, we sought to determine whether mortality among subjects with intracranial aneurysm (affected) was higher and related to rupture, compared with unaffected family members.
Subjects enrolled in the Familial Intracranial Aneurysm protocol were contacted yearly and their status was obtained. If reported to be deceased, the cause of death was verified by available records. A Cox proportional hazards model was utilized to compare mortality rates.
Of the 2794 subjects, 1073 were affected and 1721 were unaffected. There were 8525 person-years of follow-up (mean 3·05 ± 1·73 years) and 85 deaths. Age at study entry for the affected (58·4 ± 11·9 years) was significantly older (P < 0·0001) than for the unaffected (52·2 ± 16·1). After adjusting for age, the overall mortality rate for the affected subjects was not significantly different from that for the unaffected (Rate Ratio [RR] 1·26, 95% confidence interval 0·82-1·93, P = 0·292). There was a strong effect modification due to age. The mortality rate ratio of the affected to the unaffected who were ≤60 years of age was RR = 3·48 (95% confidence interval: 1·59-7·63, P = 0·002), the rate for the affected subjects who were ≥60 was less than the rate for the unaffected (RR = 0·69, 95% confidence interval: 0·404-1·19, P = 0·178). The affected who had ruptures had 2·62 times the mortality rate as those without ruptures (95% confidence interval 1·43-4·80, P = 0·002).
The overall mortality was similar for the affected and unaffected subjects in this cohort. Among the affected only, those with ruptured intracranial aneurysm had a higher mortality rate than those without ruptured.
有报道称，蛛网膜下腔出血伴颅内动脉瘤患者的死亡率更高。
在颅内动脉瘤家族中，我们试图确定颅内动脉瘤患者（受影响者）的死亡率是否更高，且与破裂有关，与未受影响的家族成员相比。
每年联系入组家族性颅内动脉瘤研究方案的受试者，获取其生存状态。若报告死亡，通过可利用的记录来核实死亡原因。利用 Cox 比例风险模型来比较死亡率。
在 2794 名受试者中，1073 名受影响，1721 名不受影响。共有 8525 人年的随访（平均 3.05±1.73 年）和 85 例死亡。受影响者（58.4±11.9 岁）的入组年龄明显大于未受影响者（52.2±16.1 岁）（P<0.0001）。校正年龄后，受影响者的总体死亡率与未受影响者无显著差异（率比 1.26，95%置信区间 0.82-1.93，P=0.292）。年龄有强烈的修饰作用。≤60 岁的受影响者与未受影响者的死亡率比为 RR=3.48（95%置信区间：1.59-7.63，P=0.002），≥60 岁的受影响者死亡率小于未受影响者（RR=0.69，95%置信区间：0.404-1.19，P=0.178）。有破裂的受影响者的死亡率是无破裂者的 2.62 倍（95%置信区间 1.43-4.80，P=0.002）。
在本队列中，受影响者与未受影响者的总体死亡率相似。仅在受影响者中，破裂的颅内动脉瘤患者的死亡率高于无破裂者。
