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Sex Difference and Rupture Rate of Intracranial Aneurysms: An Individual Patient Data Meta-Analysis.
Zuurbier, Charlotte C M; Molenberg, Rob; Mensing, Liselore A; Wermer, Marieke J H; Juvela, Seppo; Lindgren, Antti E; Jääskeläinen, Juha E; Koivisto, Timo; Yamazaki, Tomosato; Uyttenboogaart, Maarten; van Dijk, J Marc C; Aalbers, Marlien W; Morita, Akio; Tominari, Shinjiro; Arai, Hajime; Nozaki, Kazuhiko; Murayama, Yuichi; Ishibashi, Toshihiro; Takao, Hiroyuki; Gondar, Renato; Bijlenga, Philippe; Rinkel, Gabriel J E; Greving, Jacoba P; Ruigrok, Ynte M.
Afiliação
  • Zuurbier CCM; UMC Utrecht Brain Center, Department of Neurology and Neurosurgery (C.C.M.Z, L.A.M., G.J.E.R., Y.M.R.), University Medical Center Utrecht, the Netherlands.
  • Molenberg R; Departments of Neurosurgery (R.M., J.M.C.v.D., M.W.A.), University Medical Center Groningen, the Netherlands.
  • Mensing LA; UMC Utrecht Brain Center, Department of Neurology and Neurosurgery (C.C.M.Z, L.A.M., G.J.E.R., Y.M.R.), University Medical Center Utrecht, the Netherlands.
  • Wermer MJH; Department of Neurology, Leiden University Medical Center, the Netherlands (M.J.H.W.).
  • Juvela S; Department of Clinical Neurosciences, University of Helsinki, Finland (S.J.).
  • Lindgren AE; Department of Clinical Radiology (A.E.L, J.E.J., T.K.), Kuopio University Hospital, Finland.
  • Jääskeläinen JE; Neurosurgery of NeuroCenter (A.E.L, J.E.J., T.K.), Kuopio University Hospital, Finland.
  • Koivisto T; Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio (A.E.L, J.E.J., T.K.).
  • Yamazaki T; Department of Clinical Radiology (A.E.L, J.E.J., T.K.), Kuopio University Hospital, Finland.
  • Uyttenboogaart M; Neurosurgery of NeuroCenter (A.E.L, J.E.J., T.K.), Kuopio University Hospital, Finland.
  • van Dijk JMC; Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio (A.E.L, J.E.J., T.K.).
  • Aalbers MW; Department of Clinical Radiology (A.E.L, J.E.J., T.K.), Kuopio University Hospital, Finland.
  • Morita A; Neurosurgery of NeuroCenter (A.E.L, J.E.J., T.K.), Kuopio University Hospital, Finland.
  • Tominari S; Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio (A.E.L, J.E.J., T.K.).
  • Arai H; Department of Neurosurgery, National Hospital Organization, Mito Medical Center, Japan (T.Y.).
  • Nozaki K; Neurology and Medical Imaging Center (M.U.), University Medical Center Groningen, the Netherlands.
  • Murayama Y; Departments of Neurosurgery (R.M., J.M.C.v.D., M.W.A.), University Medical Center Groningen, the Netherlands.
  • Ishibashi T; Departments of Neurosurgery (R.M., J.M.C.v.D., M.W.A.), University Medical Center Groningen, the Netherlands.
  • Takao H; Medical Center UCAS Japan Coordinating Office- University of Tokyo- Nippon Medical School, Neurological Surgery (A.M.).
  • Gondar R; Department of Health Informatics, School of Public Health, Kyoto University, Japan (S.T.).
  • Bijlenga P; Department of Neurosurgery, Juntendo University- Medical School, Tokyo, Japan (H.A.).
  • Rinkel GJE; Department of Neurosurgery, Shiga University of Medical Science, Japan (K.N.).
  • Greving JP; Department of Endovascular Neurosurgery, Tokyo Jikei University School of Medicine, Japan (Y.M., T.I., H.T.).
  • Ruigrok YM; Department of Endovascular Neurosurgery, Tokyo Jikei University School of Medicine, Japan (Y.M., T.I., H.T.).
Stroke ; 53(2): 362-369, 2022 02.
Article em En | MEDLINE | ID: mdl-34983236
ABSTRACT
BACKGROUND AND

PURPOSE:

In previous studies, women had a higher risk of rupture of intracranial aneurysms than men, but female sex was not an independent risk factor. This may be explained by a higher prevalence of patient- or aneurysm-related risk factors for rupture in women than in men or by insufficient power of previous studies. We assessed sex differences in rupture rate taking into account other patient- and aneurysm-related risk factors for aneurysmal rupture.

METHODS:

We searched Embase and Pubmed for articles published until December 1, 2020. Cohorts with available individual patient data were included in our meta-analysis. We compared rupture rates of women versus men using a Cox proportional hazard regression model adjusted for the PHASES score (Population, Hypertension, Age, Size of Aneurysm, Earlier Subarachnoid Hemorrhage From Another Aneurysm, Site of Aneurysm), smoking, and a positive family history of aneurysmal subarachnoid hemorrhage.

RESULTS:

We pooled individual patient data from 9 cohorts totaling 9940 patients (6555 women, 66%) with 12 193 unruptured intracranial aneurysms, and 24 357 person-years follow-up. Rupture occurred in 163 women (rupture rate 1.04%/person-years [95% CI, 0.89-1.21]) and 63 men (rupture rate 0.74%/person-years [95% CI, 0.58-0.94]). Women were older (61.9 versus 59.5 years), were less often smokers (20% versus 44%), more often had internal carotid artery aneurysms (24% versus 17%), and larger sized aneurysms (≥7 mm, 24% versus 23%) than men. The unadjusted women-to-men hazard ratio was 1.43 (95% CI, 1.07-1.93) and the adjusted women/men ratio was 1.39 (95% CI, 1.02-1.90).

CONCLUSIONS:

Women have a higher risk of aneurysmal rupture than men and this sex difference is not explained by differences in patient- and aneurysm-related risk factors for aneurysmal rupture. Future studies should focus on the factors explaining the higher risk of aneurysmal rupture in women.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Aneurisma Intracraniano / Aneurisma Roto Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2022 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Aneurisma Intracraniano / Aneurisma Roto Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2022 Tipo de documento: Article