| Related Articles |
Predictors of Shunt-dependent Hydrocephalus after Aneurysmal Subarachnoid Hemorrhage? A systematic review and meta-analysis.
World Neurosurg. 2017 Jun 23;:
Authors: Xie Z, Hu X, Zan X, Lin S, Li H, You C
Abstract
BACKGROUND: Hydrocephalus is a well-recognized complication following aneurysmal subarachnoid hemorrhage (aSAH). This study aimed to identify predictors for shunt-dependent hydrocephalus (SDHC) following aSAH and via a systematic review and meta-analysis.
METHODS: A systematic search was conducted using the Embase, MEDLINE, and Web of Science databases for studies pertaining to aSAH and SDHC. Risk factors were assessed by meta-analysis when they were reported by at least two studies. The results were presented as odd ratios (OR) or risk ratios (RR) according to the study design with the corresponding 95% confidence intervals (CI).
RESULTS: 25 studies were included. In primary analysis of 14 potential risk factors, 12 were identified as predictors of SDHC following aSAH including age ≥50 years, female gender, high Hunt-Hess grade, Glasgow coma scale ≤8, Fisher grade ≥3, acute hydrocephalus, external ventricular drainage insertion, intraventricular hemorrhage, post circulation aneurysm, anterior communicating artery aneurysm, meningitis, and rebleeding. The meta-analysis based on cohort studies found a significantly increased risk for SDHC in aSAH patients treated by coiling (RR 1.16, 95% CI 1.05-1.29), while the meta-analysis based on case-controlled studies failed to replicate this finding (OR 1.27, 95% CI 0.95-1.71).
CONCLUSION: Several new predictors of SDHC following aSAH were identified that may assist with the early recognition and prevention of SDHC. The controversial evidence found in this study was insufficient to support potential of neurosurgical clipping for reducing the risk of shunt-dependency. Further well-designed studies are warranted to explore the effect of treatment modality on SDHC risk.
PMID: 28652120 [PubMed - as supplied by publisher]
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2tk6AaM
via IFTTT
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου