The relationship between staying up late and risk of intracranial aneurysm rupture: A single-center study

Comprehensive analysis of risk factors for intracranial aneurysm rupture: a retrospective cohort study

Background

Intracranial aneurysms (IAs) can lead to subarachnoid hemorrhage, a life-threatening event associated with high morbidity and mortality. Identifying individuals at elevated risk is crucial for guiding timely interventions and improving patient outcomes.

Methods

In this retrospective cohort study, 850 patients who received interventional or surgical treatment for IAs between January 2018 and January 2024 were included. Demographic data (e.g., age, sex), lifestyle factors, and comorbidities were recorded. Hematologic, biochemical, and coagulation parameters were measured to evaluate their potential association with IA rupture. A univariate logistic regression was first conducted, followed by a multivariate logistic regression with a backward stepwise approach to derive the final predictive model. The model's performance was assessed using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis.

Results

Younger age, female sex, higher neutrophil count, lower hematocrit, and elevated markers of inflammation and coagulation (including fibrinogen and D-dimer) emerged as key risk factors. Electrolyte imbalances, such as low potassium, and elevated lactate dehydrogenase were also significantly associated with rupture. The optimized model achieved an AUC of 0.815, with good calibration and clinical utility indicated by decision curve analysis.

Conclusion

These findings highlight the interplay of demographic, inflammatory, metabolic, and coagulation parameters in determining rupture risk in patients with IAs. Incorporating these risk factors into clinical practice may enhance early detection, guide targeted prevention strategies, and ultimately improve outcomes for high-risk individuals.

Clinical Study on Characteristics and Risk Factors of Coronary Artery Lesions in Young Patients with Acute Myocardial Infarction

Epidemiological evidence suggests that the incidence of acute myocardial infarction (AMI) among people under 40 years of age has an increasing trend in recent years. Smoking, hypertension, diabetes mellitus, family history, and gender (male) are considered as classic risk factors for CHD, but the pathogenesis of CHD in young people is not exactly the same. Moreover, the relationship between the pattern of coronary artery disease and risk factors in young patients with acute myocardial infarction is inconclusive. In this study, we retrospectively studied the clinical data of 150 AMI patients treated in our hospital from January 2020 to May 2021. The patients were divided into the young group and elderly group according to the difference in age. The number of coronary artery lesions, the degree of coronary artery stenosis, the distribution dominance typing, the position of the lesions, and the presence of collateral circulation were observed and compared between the two groups. Multivariate logistic regression analysis was used to investigate the risk factors affecting coronary artery lesions in young patients with AMI. The results showed that the number of coronary lesions in young patients with AMI was mainly single-vessel, and the dominant type of distribution was mainly right dominant type. The stenosis degree is lighter than that of elderly patients, and the incidence of collateral circulation is lower than that of elderly patients, but the position of the lesions has no obvious regular. Smoking, staying up late, HDL-C, and LDL-C/ApoB were independent factors affecting the number of coronary artery lesions, and the changes of HDL-C and LDL-C/ApoB had an important influence on the degree of coronary stenosis in young patients. This provides a new idea for clinical treatment.