Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis.

<h4>Background and purpose</h4>Spontaneous intracerebral hemorrhage (ICH) is a devastating form of stroke with a poor prognosis overall. We conducted a systematic review and meta-analysis to identify and describe factors associated with early neurologic deterioration (END) after ICH.<...

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Autores principales:	Adrian V Specogna, Tanvir C Turin, Scott B Patten, Michael D Hill
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5e6cadfdd753405f98420262b75f9a02
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spelling	oai:doaj.org-article:5e6cadfdd753405f98420262b75f9a022021-11-18T08:20:11ZFactors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis.1932-620310.1371/journal.pone.0096743https://doaj.org/article/5e6cadfdd753405f98420262b75f9a022014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24809990/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background and purpose</h4>Spontaneous intracerebral hemorrhage (ICH) is a devastating form of stroke with a poor prognosis overall. We conducted a systematic review and meta-analysis to identify and describe factors associated with early neurologic deterioration (END) after ICH.<h4>Methods</h4>We sought to identify any factor which could be prognostic in the absence of an intervention. The Cochrane Library, EMBASE, the Global Health Library, and PubMed were searched for primary studies from the years 1966 to 2012 with no restrictions on language or study design. Studies of patients who received a surgical intervention or specific experimental therapies were excluded. END was defined as death, or worsening on a reliable outcome scale within seven days after onset.<h4>Results</h4>7,172 abstracts were reviewed, 1,579 full-text papers were obtained and screened. 14 studies were identified; including 2088 patients. Indices of ICH severity such as ICH volume (univariate combined OR per ml:1.37, 95%CI: 1.12-1.68), presence of intraventricular hemorrhage (2.95, 95%CI: 1.57-5.55), glucose concentration (per mmol/l: 2.14, 95%CI: 1.03-4.47), fibrinogen concentration (per g/l: 1.83, 95%CI: 1.03-3.25), and d-dimer concentration at hospital admission (per mg/l: 4.19, 95%CI: 1.88-9.34) were significantly associated with END after random-effects analyses. Whereas commonly described risk factors for ICH progression such as blood pressure, history of hypertension, and ICH growth were not.<h4>Conclusions</h4>This study summarizes the evidence to date on early ICH prognosis and highlights that the amount and distribution of the initial bleed at hospital admission may be the most important factors to consider when predicting early clinical outcomes.Adrian V SpecognaTanvir C TurinScott B PattenMichael D HillPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 5, p e96743 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Adrian V Specogna Tanvir C Turin Scott B Patten Michael D Hill Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis.
description	<h4>Background and purpose</h4>Spontaneous intracerebral hemorrhage (ICH) is a devastating form of stroke with a poor prognosis overall. We conducted a systematic review and meta-analysis to identify and describe factors associated with early neurologic deterioration (END) after ICH.<h4>Methods</h4>We sought to identify any factor which could be prognostic in the absence of an intervention. The Cochrane Library, EMBASE, the Global Health Library, and PubMed were searched for primary studies from the years 1966 to 2012 with no restrictions on language or study design. Studies of patients who received a surgical intervention or specific experimental therapies were excluded. END was defined as death, or worsening on a reliable outcome scale within seven days after onset.<h4>Results</h4>7,172 abstracts were reviewed, 1,579 full-text papers were obtained and screened. 14 studies were identified; including 2088 patients. Indices of ICH severity such as ICH volume (univariate combined OR per ml:1.37, 95%CI: 1.12-1.68), presence of intraventricular hemorrhage (2.95, 95%CI: 1.57-5.55), glucose concentration (per mmol/l: 2.14, 95%CI: 1.03-4.47), fibrinogen concentration (per g/l: 1.83, 95%CI: 1.03-3.25), and d-dimer concentration at hospital admission (per mg/l: 4.19, 95%CI: 1.88-9.34) were significantly associated with END after random-effects analyses. Whereas commonly described risk factors for ICH progression such as blood pressure, history of hypertension, and ICH growth were not.<h4>Conclusions</h4>This study summarizes the evidence to date on early ICH prognosis and highlights that the amount and distribution of the initial bleed at hospital admission may be the most important factors to consider when predicting early clinical outcomes.
format	article
author	Adrian V Specogna Tanvir C Turin Scott B Patten Michael D Hill
author_facet	Adrian V Specogna Tanvir C Turin Scott B Patten Michael D Hill
author_sort	Adrian V Specogna
title	Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis.
title_short	Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis.
title_full	Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis.
title_fullStr	Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis.
title_full_unstemmed	Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis.
title_sort	factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/5e6cadfdd753405f98420262b75f9a02
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Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis.

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