Department of Health Informatics, Kyoto University School of Public Health, Kyoto.
Unruptured Cerebral Aneurysm Study Japan Coordinating Office, University of Tokyo, Tokyo.
Ann Neurol. 2015 Jun;77(6):1050-9. doi: 10.1002/ana.24400. Epub 2015 Apr 22.
To build a prediction model that estimates the 3-year rupture risk of unruptured saccular cerebral aneurysms.
Survival analysis was done using each aneurysm as the unit for analysis. Derivation data were from the Unruptured Cerebral Aneurysm Study (UCAS) in Japan. It consists of patients with unruptured cerebral aneurysms enrolled between 2000 and 2004 at neurosurgical departments at tertiary care hospitals in Japan. The model was presented as a scoring system, and aneurysms were classified into 4 risk grades by predicted 3-year rupture risk: I, < 1%; II, 1 to 3%; III, 3 to 9%, and IV, >9%. The discrimination property and calibration plot of the model were evaluated with external validation data. They were a combination of 3 Japanese cohort studies: UCAS II, the Small Unruptured Intracranial Aneurysm Verification study, and the study at Jikei University School of Medicine.
The derivation data include 6,606 unruptured cerebral aneurysms in 5,651 patients. During the 11,482 aneurysm-year follow-up period, 107 ruptures were observed. The predictors chosen for the scoring system were patient age, sex, and hypertension, along with aneurysm size, location, and the presence of a daughter sac. The 3-year risk of rupture ranged from <1% to >15% depending on the individual characteristics of patients and aneurysms. External validation indicated good discrimination and calibration properties.
A simple scoring system that only needs easily available patient and aneurysmal information was constructed. This can be used in clinical decision making regarding management of unruptured cerebral aneurysms.
建立一个预测模型，估计未破裂囊状脑动脉瘤的 3 年破裂风险。
使用每个动脉瘤作为分析单位进行生存分析。推导数据来自日本未破裂脑动脉瘤研究（UCAS）。它包括 2000 年至 2004 年在日本三级医院神经外科部门登记的未破裂脑动脉瘤患者。该模型以评分系统的形式呈现，根据预测的 3 年破裂风险，将动脉瘤分为 4 个风险等级：I 级，<1%；II 级，1%至 3%；III 级，3%至 9%；IV 级，>9%。通过外部验证数据评估模型的判别性能和校准图。它们是三个日本队列研究的组合：UCAS II、小型未破裂颅内动脉瘤验证研究和日本顺天堂大学医学院的研究。
推导数据包括 5651 名患者的 6606 个未破裂脑动脉瘤。在 11482 个动脉瘤年的随访期间，观察到 107 例破裂。评分系统选择的预测因子是患者年龄、性别和高血压，以及动脉瘤大小、位置和子囊的存在。根据患者和动脉瘤的个体特征，破裂的 3 年风险范围从<1%到>15%不等。外部验证表明具有良好的判别和校准性能。
构建了一个仅需要易于获得的患者和动脉瘤信息的简单评分系统。这可用于未破裂脑动脉瘤管理的临床决策。
