Hyperacute prediction of functional outcome in spontaneous intracerebral haemorrhage: systematic review and meta-analysis

被引:10
作者
Hammerbeck, Ulrike [1 ,2 ,3 ]
Abdulle, Aziza [2 ]
Heal, Calvin [2 ,4 ]
Parry-Jones, Adrian R. [1 ,2 ,5 ]
机构
[1] Northern Care Alliance & Univ Manchester, Manchester Acad, Hlth Sci Ctr, Geoffrey Jefferson Brain Res Ctr, Manchester, Lancs, England
[2] Univ Manchester, Div Cardiovasc Sci, Fac Biol Med & Hlth, Manchester, Lancs, England
[3] Manchester Metropolitan Univ, Sch Physiotherapy, Fac Hlth & Educ, Manchester, Lancs, England
[4] Univ Manchester, Div Populat Hlth, Fac Biol Med & Hlth, Manchester, Lancs, England
[5] Salford Royal NHS Fdn Trust, Manchester Ctr Clin Neurosci, Salford, Lancs, England
关键词
Intracerebral Haemorrhage; functional outcome; predictors; BLOOD-PRESSURE REDUCTION; HEMATOMA GROWTH; PROGNOSTIC-SIGNIFICANCE; POOR OUTCOMES; STROKE; SIGN; MANAGEMENT; MORTALITY; ADMISSION; EXPANSION;
D O I
10.1177/23969873211067663
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose To describe the association between factors routinely available in hyperacute care of spontaneous intracerebral haemorrhage (ICH) patients and functional outcome. Methods We searched Medline, Embase and CINAHL in February 2020 for original studies reporting associations between markers available within six hours of arrival in hospital and modified Rankin Scale (mRS) at least 6 weeks post-ICH. A random-effects meta-analysis was performed where three or more studies were included. Findings Thirty studies were included describing 40 markers. Ten markers underwent meta-analysis and age (OR = 1.06; 95%CI = 1.05 to 1.06; p < 0.001), pre-morbid dependence (mRS, OR = 1.73; 95%CI = 1.52 to 1.96; p < 0.001), level of consciousness (Glasgow Coma Scale, OR = 0.82; 95%CI = 0.76 to 0.88; p < 0.001), stroke severity (National Institutes of Health Stroke Scale, OR=1.19; 95%CI = 1.13 to 1.25; p < 0.001), haematoma volume (OR = 1.12; 95%CI=1.07 to 1.16; p < 0.001), intraventricular haemorrhage (OR = 2.05; 95%CI = 1.68 to 2.51; p < 0.001) and deep (vs. lobar) location (OR = 2.64; 95%CI = 1.65 to 4.24; p < 0.001) were predictive of outcome but systolic blood pressure, CT hypodensities and infratentorial location were not. Of the remaining markers, sex, medical history (diabetes, hypertension, prior stroke), prior statin, prior antiplatelet, admission blood results (glucose, cholesterol, estimated glomerular filtration rate) and other imaging features (midline shift, spot sign, sedimentation level, irregular haematoma shape, ultraearly haematoma growth, Graeb score and onset to CT time) were associated with outcome. Conclusion Multiple demographic, pre-morbid, clinical, imaging and laboratory factors should all be considered when prognosticating in hyperacute ICH. Incorporating these in to accurate and precise models will help to ensure appropriate levels of care for individual patients.
引用
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页码:6 / 14
页数:9
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