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

doi:10.3390/brainsci11040445

Open AccessArticle

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

by

Hye-Mee Kwon

,

In-Gu Jun

,

Kyoung-Sun Kim

,

Young-Jin Moon

,

In Young Huh

,

Jungmin Lee

,

Jun-Gol Song

^*

and

Gyu-Sam Hwang

Department of Anesthesiology and Pain Medicine, Laboratory for Cardiovascular Dynamics, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea

^*

Author to whom correspondence should be addressed.

Brain Sci. 2021, 11(4), 445; https://doi.org/10.3390/brainsci11040445

Submission received: 3 March 2021 / Revised: 24 March 2021 / Accepted: 27 March 2021 / Published: 31 March 2021

(This article belongs to the Section Neurotechnology and Neuroimaging)

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Abstract

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.

Keywords: end-stage liver disease; intracranial aneurysm; mortality; prediction; intracranial hemorrhage

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MDPI and ACS Style

Kwon, H.-M.; Jun, I.-G.; Kim, K.-S.; Moon, Y.-J.; Huh, I.Y.; Lee, J.; Song, J.-G.; Hwang, G.-S. Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant. Brain Sci. 2021, 11, 445. https://doi.org/10.3390/brainsci11040445

AMA Style

Kwon H-M, Jun I-G, Kim K-S, Moon Y-J, Huh IY, Lee J, Song J-G, Hwang G-S. Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant. Brain Sciences. 2021; 11(4):445. https://doi.org/10.3390/brainsci11040445

Chicago/Turabian Style

Kwon, Hye-Mee, In-Gu Jun, Kyoung-Sun Kim, Young-Jin Moon, In Young Huh, Jungmin Lee, Jun-Gol Song, and Gyu-Sam Hwang. 2021. "Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant" Brain Sciences 11, no. 4: 445. https://doi.org/10.3390/brainsci11040445

APA Style

Kwon, H.-M., Jun, I.-G., Kim, K.-S., Moon, Y.-J., Huh, I. Y., Lee, J., Song, J.-G., & Hwang, G.-S. (2021). Rupture Risk of Intracranial Aneurysm and Prediction of Hemorrhagic Stroke after Liver Transplant. Brain Sciences, 11(4), 445. https://doi.org/10.3390/brainsci11040445

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

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