Abstract :
Background and Purpose: We aimed to investigate the effect of smoking on the risk of intracranial
aneurysm (IA) rupture (IAR), specifically relationship between the number of cigarettes smoked per day
(CPD) or smoking index and the risk of IAR.
Materials and Methods: We performed a single-center case–control study of consecutive patients
evaluated or treated for IA at our institution from June 2017 to July 2018. Cases were patients with a
ruptured IA. Two age- and sex-matched controls with an unruptured IA were included per case. Conditional
logistic regression models were used to assess the relationship between both the CPD and smoking index
(CPD x years of smoking) and IAR.
Results: The study population included 300 cases of IAR and 300 controls. The higher IAR risk was
associated with cigarette smoking. Our subgroup analysis of smokers revealed a significant association
between IAR risk and current smoking (OR, 2.8; 95% CI, 1.2–6.3; P = 0.012), current heavy smoking (CPD
>20) (OR, 3.9; 95% CI, 1.4–11.0; P = 0.007), and a smoking index >800 (OR, 11.4; 95% CI, 2.3–24.5; P
= 0.003).
Conclusion: A dose–response relationship has been noted for intensity and duration of smoking
consumption and increased risk of IAR. As smoking is modifiable, this finding is important to managing
patients with IAs to quit or reduce smoking prior to life-threatening subarachnoid hemorrhage.
Keyword :
Smoking index, Quantify cumulative, Smoking exposure.