The Cardiovascular
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PHASES Score

Estimates 5-year risk of rupture for an unruptured intracranial aneurysm.

PHASES Score
Population
Hypertension
Age >=70 years
Aneurysm size
Earlier SAH from a different, already-treated aneurysm
Aneurysm site
Result0 points

Estimated 5-year absolute risk of aneurysm rupture is about 0.4 %.

5-year rupture risk
0.4 %

When to use

  • Estimating 5-year rupture risk for an unruptured intracranial aneurysm to help weigh observation versus preventive treatment.

Formula

Sum of points for Population, Hypertension, Age >=70, aneurysm Size, Earlier SAH from another aneurysm, and Site, then mapped to a 5-year absolute rupture risk from the derivation cohort's Cox model.

Pearls and pitfalls

  • Derived from a pooled analysis of 8382 patients in 6 prospective cohorts.
  • Does not capture all rupture risk factors (e.g., aneurysm morphology, smoking, family history) and should complement, not replace, clinical judgement.

References

  1. Greving JP, et al. Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies. Lancet Neurol. 2014;13(1):59-66.