Development and validation of a novel nomogram to predict aneurysm rupture in patients with multiple intracranial aneurysms:a multicentre retrospective study

作     者：Xin Feng Xin Tong Fei Peng Hao Niu Peng Qi Jun Lu Yang Zhao Weitao Jin Zhongxue Wu Yuanli Zhao Aihua Liu Daming Wang 

作者机构：Neurosurgery DepartmentBeijing HospitalBeijingBeijingChina Neurointervention CenterBeijing Neurosurgical InstituteBeijingChina Neurointervention CenterBeijing Tiantan HospitalBeijingChina Neurosurgery DepartmentPeking University International HospitalBeijingChina 

出 版 物：《Stroke & Vascular Neurology》 (卒中与血管神经病学（英文）)

年 卷 期：2021年第6卷第3期

页      面：433-440,I0058-I0072页

核心收录：

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

基　　金：supported by the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(No.2019TX320002) the Natural Science Foundation of China(No.81771233) 

主　　题：rupture patients aneurysm 

摘      要：Background and purpose Approximately 15%–45%of patients with unruptured intracranial aneurysms have multiple intracranial aneurysms(MIAs).Determining which one is most likely to rupture is extremely important for treatment decision making for MIAs *** study aimed to develop and validate a nomogram to evaluate the per-aneurysm rupture risk of MIAs *** A total of 1671 IAs from 700 patients with MIAs were randomly dichotomised into derivation and validation *** logistic regression analysis was used to select predictors and construct a nomogram model for aneurysm rupture risk assessment in the derivation *** discriminative accuracy,calibration performance and clinical usefulness of this nomogram were *** also developed a multivariate model for a subgroup of 158 subarachnoid haemorrhage(SAH)patients and compared its performance with the nomogram *** Multivariate analyses identified seven variables that were significantly associated with IA rupture(history of SAH,alcohol consumption,female sex,aspect ratio1.5,posterior circulation,irregular shape and bifurcation location).The clinical and morphological-based MIAs(CMB-MIAs)nomogram model showed good calibration and discrimination(derivation set:area under the curve(AUC)=0.740 validation set:AUC=0.772).Decision curve analysis demonstrated that the nomogram was clinically *** with the nomogram model,the AUC of multivariate model developed from SAH patients had lower value of *** This CMB-MIAs nomogram for MIAs rupture risk is the first to be developed and validated in a large multi-institutional *** nomogram could be used in decision-making and risk stratification in MIAs patients.