Time trends in the risk of delayed cerebral ischemia after subarachnoid hemorrhage
| Autor: | Luigi Rigante, Jasper Hans van Lieshout, Mervyn D. I. Vergouwen, Carlijn H. S. van Griensven, Priya Vart, Lars van der Loo, Joost de Vries, Ruben Saman Vinke, Nima Etminan, Rene Aquarius, Andreas Gruber, J Mocco, Babu G. Welch, Tomas Menovsky, Catharina J. M. Klijn, Ronald H. M. A. Bartels, Menno R. Germans, Daniel Hänggi, Hieronymus D. Boogaarts |
|---|---|
| Přispěvatelé: | MUMC+: MA AIOS Neurologie (9), MUMC+: MA AIOS Neurochirurgie (9), RS: FHML non-thematic output, University of Zurich, Rigante, Luigi |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Time Factors
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] VASOSPASM 610 Medicine & health CASE-FATALITY Brain Ischemia 10180 Clinic for Neurosurgery All institutes and research themes of the Radboud University Medical Center Humans Vasospasm Intracranial Randomized Controlled Trials as Topic Other Research Radboud Institute for Health Sciences [Radboudumc 0] General Medicine Subarachnoid Hemorrhage Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] 2746 Surgery Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] meta-analysis 2728 Neurology (clinical) delayed ischemic neurologic deficit cerebral vasospasm delayed cerebral ischemia Surgery Neurology (clinical) Human medicine aneurysmal subarachnoid hemorrhage Renal disorders Radboud Institute for Health Sciences [Radboudumc 11] CLINICAL-TRIALS |
| Zdroj: | Neurosurgical Focus, 52(3):2. American Association of Neurological Surgeons Neurosurgical Focus, 52 Neurosurgical Focus, 52, 3 Neurosurgical Focus |
| ISSN: | 1092-0684 |
| Popis: | OBJECTIVE Delayed cerebral ischemia (DCI) contributes to morbidity and mortality after aneurysmal subarachnoid hemorrhage (aSAH). Continuous improvement in the management of these patients, such as neurocritical care and aneurysm repair, may decrease the prevalence of DCI. In this study, the authors aimed to investigate potential time trends in the prevalence of DCI in clinical studies of DCI within the last 20 years. METHODS PubMed, Embase, and the Cochrane library were searched from 2000 to 2020. Randomized controlled trials that reported clinical (and radiological) DCI in patients with aSAH who were randomized to a control group receiving standard care were included. DCI prevalence was estimated by means of random-effects meta-analysis, and subgroup analyses were performed for the DCI sum score, Fisher grade, clinical grade on admission, and aneurysm treatment method. Time trends were evaluated by meta-regression. RESULTS The search strategy yielded 5931 records, of which 58 randomized controlled trials were included. A total of 4424 patients in the control arm were included. The overall prevalence of DCI was 0.29 (95% CI 0.26–0.32). The event rate for prevalence of DCI among the high-quality studies was 0.30 (95% CI 0.25–0.34) and did not decrease over time (0.25% decline per year; 95% CI −2.49% to 1.99%, p = 0.819). DCI prevalence was higher in studies that included only higher clinical or Fisher grades, and in studies that included only clipping as the treatment modality. CONCLUSIONS Overall DCI prevalence in patients with aSAH was 0.29 (95% CI 0.26–0.32) and did not decrease over time in the control groups of the included randomized controlled trials. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|