The PHASES score: To treat or not to treat? Retrospective evaluation of the risk of rupture of intracranial aneurysms in patients with aneurysmal subarachnoid hemorrhage.
BACKGROUND AND PURPOSE
The PHASES score was formulated to predict the 5-year risk of rupture for intracranial aneurysms. We retrospectively analyzed all patients treated in our institution for aneurysmal SAH and applied the PHASES score to estimate the probable predicted risk of bleeding in this group of patients.


METHODS
Between February 2015 and August 2018, all patients with aneurysmal SAH were retrospectively analyzed and the PHASES score was applied. A total of 155 patients were included with a mean age of 53.8years, including 60 males and 95 females.


RESULTS
Of our patients 110 (70.9%) had a PHASES score of below or equal to 5, with a hemorrhagic risk of up to 1.3% over 5years. If we analyze the patients with a risk of below 2% this figure increases to 122 patients (78.7%). Of these 99.3% were European and 0.6% were Japanese (1 patient). In 86 patients (55.4%), the aneurysm was smaller than 5mm and in 10 patients (6.4%) the aneurysm was located in the posterior circulation.


CONCLUSION
Of our patients 78.7% had less than a 2% 5-year rupture risk based on their PHASES score, highlighting the discrepancy of the rupture risk calculated with the PHASES score when hypothetically applied to this group of patients. In the hypothetical scenario that our patients had unruptured aneurysms, our retrospective analysis shows that the PHASES score may only provide a weak tool for clinicians to use in the decision-making process as to whether or not to treat these aneurysms.
['Pagiola|Igor|I|', 'Mihalea|Cristian|C|', 'Caroff|Jildaz|J|', 'Ikka|Leon|L|', 'Chalumeau|Vanessa|V|', 'Iacobucci|Marta|M|', 'Ozanne|Augustin|A|', 'Gallas|Sophie|S|', 'Marques|Marcio|M|', 'Nalli|Darcio|D|', 'Carrete|Henrique|H|', 'Caldas|José Guilherme|JG|', 'Frudit|Michel Eli|ME|', 'Moret|Jacques|J|', 'Spelle|Laurent|L|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D017542:Aneurysm, Ruptured D003657:Decision Making D005060:Europe D005260:Female D006801:Humans D002532:Intracranial Aneurysm D008297:Male D008875:Middle Aged D012189:Retrospective Studies D018570:Risk Assessment D012307:Risk Factors D013345:Subarachnoid Hemorrhage
Risk of rupture Intracranial aneurysms Subarachnoid hemorrhage Unruptured aneurysm