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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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Background and purpose Prediction of intracranial aneurysm growth risk can assist physicians in planning of follow-up imaging of conservatively managed unruptured intracranial aneurysms. We therefore aimed to externally validate the ELAPSS (Earlier subarachnoid hemorrhage, aneurysm Location, Age, Population, aneurysm Size and Shape) score for prediction of the risk of unruptured intracranial aneurysm growth. Methods From 11 international cohorts of patients ≥18 years with ≥1 unruptured intracranial aneurysm and ≥6 months of radiological follow-up, we collected data on the predictors of the ELAPSS score, and calculated 3- and 5-year absolute growth risks according to the score. Model performance was assessed in terms of calibration (predicted versus observed risk) and discrimination (c-statistic). Results We included 1,072 patients with a total of 1,452 aneurysms. During 4,268 aneurysm-years of follow-up, 199 (14%) aneurysms enlarged. Calibration was comparable to that of the followdevelopment cohort with the overall observed risks within the range of the expected risks. The c-statistic was 0.69 (95% confidence interval [CI], 0.64 to 0.73) at 3 years, compared to 0.72 (95% CI, 0.68 to 0.76) in the development cohort. At 5 years, the c-statistic was 0.68 (95% CI, 0.64 to 0.72), compared to 0.72 (95% CI, 0.68 to 0.75) in the development cohort. Conclusions The ELAPSS score showed accurate calibration for 3- and 5-year risks of aneurysm growth and modest discrimination in our external validation cohort. This indicates that the score is externally valid and could assist patients and physicians in predicting growth of unruptured intracranial aneurysms and plan follow-up imaging accordingly.
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참고문헌 (17)
참고문헌 신청
Vlak MH / 2011 / Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis / Lancet Neurol 10:626~636
Gabriel RA / 2010 / Ten-year detection rate of brain arteriovenous malformations in a large, multiethnic, defined population / Stroke 41:21~26
Brown RD Jr / 2014 / Unruptured intracranial aneurysms: epidemiology, natural history, management options, and familial screening / Lancet Neurol 13:393~404
Mehan WA Jr / 2014 / Unruptured intracranial aneurysms conservatively followed with serial CT angiography: could morphology and growth predict rupture? / J Neurointerv Surg 6:761~766
Villablanca JP / 2013 / Natural history of asymptomatic unruptured cerebral aneurysms evaluated at CT angiography: growth and rupture incidence and correlation with epidemiologic risk factors / Radiology 269:258~265
Gabriel RA / 2010 / Ten-year detection rate of brain arteriovenous malformations in a large, multiethnic, defined population / Stroke 41:21~26
Brown RD Jr / 2014 / Unruptured intracranial aneurysms: epidemiology, natural history, management options, and familial screening / Lancet Neurol 13:393~404
Mehan WA Jr / 2014 / Unruptured intracranial aneurysms conservatively followed with serial CT angiography: could morphology and growth predict rupture? / J Neurointerv Surg 6:761~766
Villablanca JP / 2013 / Natural history of asymptomatic unruptured cerebral aneurysms evaluated at CT angiography: growth and rupture incidence and correlation with epidemiologic risk factors / Radiology 269:258~265
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