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Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant

Postoperative hemorrhagic stroke (HS) is a rare yet devastating complication after liver transplantation (LT). Unruptured intracranial aneurysm (UIA) may contribute to HS; however, related data are limited. We investigated UIA prevalence and aneurysmal subarachnoid hemorrhage (SAH) and HS incidence...

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Autores principales: Kwon, Hye-Mee, Jun, In-Gu, Kim, Kyoung-Sun, Moon, Young-Jin, Huh, In Young, Lee, Jungmin, Song, Jun-Gol, Hwang, Gyu-Sam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066281/
https://www.ncbi.nlm.nih.gov/pubmed/33807191
http://dx.doi.org/10.3390/brainsci11040445
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author Kwon, Hye-Mee
Jun, In-Gu
Kim, Kyoung-Sun
Moon, Young-Jin
Huh, In Young
Lee, Jungmin
Song, Jun-Gol
Hwang, Gyu-Sam
author_facet Kwon, Hye-Mee
Jun, In-Gu
Kim, Kyoung-Sun
Moon, Young-Jin
Huh, In Young
Lee, Jungmin
Song, Jun-Gol
Hwang, Gyu-Sam
author_sort Kwon, Hye-Mee
collection PubMed
description Postoperative hemorrhagic stroke (HS) is a rare yet devastating complication after liver transplantation (LT). Unruptured intracranial aneurysm (UIA) may contribute to HS; however, related data are limited. We investigated UIA prevalence and aneurysmal subarachnoid hemorrhage (SAH) and HS incidence post-LT. We identified risk factors for 1-year HS and constructed a prediction model. This study included 3544 patients who underwent LT from January 2008 to February 2019. Primary outcomes were incidence of SAH, HS, and mortality within 1-year post-LT. Propensity score matching (PSM) analysis and Cox proportional hazard analysis were performed. The prevalence of UIAs was 4.63% (n = 164; 95% confidence interval (CI), 3.95–5.39%). The 1-year SAH incidence was 0.68% (95% CI, 0.02–3.79%) in patients with UIA. SAH and HS incidence and mortality were not different between those with and without UIA before and after PSM. Cirrhosis severity, thrombocytopenia, inflammation, and history of SAH were identified as risk factors for 1-year HS. UIA presence was not a risk factor for SAH, HS, or mortality in cirrhotic patients post-LT. Given the fatal impact of HS, a simple scoring system was constructed to predict 1-year HS risk. These results enable clinical risk stratification of LT recipients with UIA and help assess perioperative HS risk before LT.
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spelling pubmed-80662812021-04-25 Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant Kwon, Hye-Mee Jun, In-Gu Kim, Kyoung-Sun Moon, Young-Jin Huh, In Young Lee, Jungmin Song, Jun-Gol Hwang, Gyu-Sam Brain Sci Article Postoperative hemorrhagic stroke (HS) is a rare yet devastating complication after liver transplantation (LT). Unruptured intracranial aneurysm (UIA) may contribute to HS; however, related data are limited. We investigated UIA prevalence and aneurysmal subarachnoid hemorrhage (SAH) and HS incidence post-LT. We identified risk factors for 1-year HS and constructed a prediction model. This study included 3544 patients who underwent LT from January 2008 to February 2019. Primary outcomes were incidence of SAH, HS, and mortality within 1-year post-LT. Propensity score matching (PSM) analysis and Cox proportional hazard analysis were performed. The prevalence of UIAs was 4.63% (n = 164; 95% confidence interval (CI), 3.95–5.39%). The 1-year SAH incidence was 0.68% (95% CI, 0.02–3.79%) in patients with UIA. SAH and HS incidence and mortality were not different between those with and without UIA before and after PSM. Cirrhosis severity, thrombocytopenia, inflammation, and history of SAH were identified as risk factors for 1-year HS. UIA presence was not a risk factor for SAH, HS, or mortality in cirrhotic patients post-LT. Given the fatal impact of HS, a simple scoring system was constructed to predict 1-year HS risk. These results enable clinical risk stratification of LT recipients with UIA and help assess perioperative HS risk before LT. MDPI 2021-03-31 /pmc/articles/PMC8066281/ /pubmed/33807191 http://dx.doi.org/10.3390/brainsci11040445 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kwon, Hye-Mee
Jun, In-Gu
Kim, Kyoung-Sun
Moon, Young-Jin
Huh, In Young
Lee, Jungmin
Song, Jun-Gol
Hwang, Gyu-Sam
Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant
title Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant
title_full Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant
title_fullStr Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant
title_full_unstemmed Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant
title_short Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant
title_sort rupture risk of intracranial aneurysm and prediction of hemorrhagic stroke after liver transplant
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066281/
https://www.ncbi.nlm.nih.gov/pubmed/33807191
http://dx.doi.org/10.3390/brainsci11040445
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