Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: PHASES score for the management of intracranial aneurysm
Authors: Bijlenga, Philippe
Gondar, Renato
Schilling, Sabine
Morel, Sandrine
Hirsch, Sven
Cuony, Johanna
Corniola, Marco-Vincenzo
Perren, Fabienne
Rüfenacht, Daniel
Schaller, Karl
DOI: 10.1161/STROKEAHA.117.017391
Published in: Stroke: A Journal of Cerebral Circulation
Volume(Issue): 48
Issue: 8
Page(s): 2105
Pages to: 2112
Issue Date: 2017
Publisher / Ed. Institution: Lippincott Williams & Wilkins
ISSN: 0039-2499
Language: English
Subjects: Hypertension; Intracranial aneurysm; Probability; Risk; Subarachnoid hemorrhage
Subject (DDC): 616.8: Neurology, diseases of nervous system
Abstract: Background and Purpose: The aim of this study is to assess whether the PHASES score allows to (1) match decisions taken by multidisciplinary team whether to observe or intervene, (2) classify patients being diagnosed with a ruptured versus unruptured intracranial aneurysm (UIA), and (3) discriminate patients at low risk of rupture from the population of patients diagnosed with intracranial aneurysm. Methods: Population-based prospective and consecutive data were collected between 2006 and 2014. Patients (n=841) were stratified into 4 groups: stable UIA; growing observed UIA; immediately treated UIA; and aneurysmal subarachnoid hemorrhage (aSAH). All patients initially observed were pooled in a follow-up UIA group; patients from growing observed UIA, immediately treated UIA, and aSAH were pooled in a high risk of rupture group. Results are expressed as median [quartile 1, quartile 3]. Results: PHASES scores of immediately treated UIA patients were significantly higher than follow-up UIA group (5 [3, 7] versus 2 [1, 4]). Patients diagnosed with UIA and PHASES score of >3 were more likely to be treated, and the score ≤3 was predictive for observation (areas under these curves=0.74). Odds of being diagnosed with an aSAH were associated with PHASES score of >3 (UIA, 4 [2, 6]; aSAH, 5 [4, 8]; areas under these curves=0.66). Scores of stable UIA patients were significantly lower than high risk of rupture group (2 [1, 4] versus 5 [4, 7]; stable UIA outcome prediction by PHASES score of ≤3: areas under these curves=0.76). Conclusions: There is a progression of PHASES score between stable UIA, growing observed UIA, immediately treated UIA, and aSAH groups. PHASES score of ≤3 is associated with a low but not negligible likelihood of aneurysm rupture, and specificity of the classifier is low.
Fulltext version: Published version
License (according to publishing contract): Licence according to publishing contract
Departement: Life Sciences and Facility Management
Organisational Unit: Institute of Computational Life Sciences (ICLS)
Published as part of the ZHAW project: AneuX
Appears in collections:Publikationen Life Sciences und Facility Management

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