This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objectives: We investigated all-cause mortality and risk factors of death of patients with unruptured intracranial aneurysms (UIAs) in a long-term follow-up study.
Methods: A total of 142 patients with 181 UIAs diagnosed between 1956 and 1978 when UIAs were not treated were included in this study. Patients were followed until death or until 2011 to 2012. Mortality rates and risk factors were studied with Kaplan-Meier survival analysis and the Cox proportional hazards regression models.
Results: During 3,530 person-years, 113 (80%) had died, giving an average annual mortality of 3.2%. Of them, 19 (17%) died of aneurysm rupture from the index UIA, 6 (5%) of other aneurysm-related causes, and 2 (2%) of unspecified subarachnoid hemorrhage. The remaining 86 died of causes unrelated to intracranial aneurysms. The cumulative death rate was 20% (95% confidence interval 14%–27%) at 10 years and 60% (52%–68%) at 30 years. Independent risk factors for subsequent death were patient age (adjusted hazard ratio 1.09 per year, 95% confidence interval 1.05–1.12, p < 0.001), male sex (2.81, 1.59–4.96, p < 0.001), heavy alcohol use (4.22, 2.22–8.02, p < 0.001), and cigarette smoking (1.72, 0.97–3.07, p = 0.064). History of hypertension, family history of subarachnoid hemorrhage, and diameter of UIA predicted death only in univariable analysis.
Conclusions: In patients of working age with a UIA, alcohol consumption and cigarette smoking are modifiable risk factors for untimely death through several causes and should be taken into account when treatment is considered.
GLOSSARY
- BP=
- blood pressure;
- CI=
- confidence interval;
- HR=
- hazard ratio;
- SAH=
- subarachnoid hemorrhage;
- UIA=
- unruptured intracranial aneurysm
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 442
Supplemental data at Neurology.org
- Received April 16, 2014.
- Accepted in final form August 28, 2014.
- © 2015 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
