Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis
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. We sought to identify any factor which could b...
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| description | 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.
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.
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.
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. |
| doi_str_mv | 10.1371/journal.pone.0096743 |
| format | Article |
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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.
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.
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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0096743</identifier><identifier>PMID: 24809990</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Anticoagulants ; Bleeding ; Blood pressure ; Cerebral Hemorrhage - diagnosis ; Clinical trials ; Disability ; Fibrin ; Fibrinogen ; Global health ; Glucose ; Health care ; Health sciences ; Hemorrhage ; Humans ; Hypertension ; Intervention ; Intracerebral hemorrhage ; Medical prognosis ; Medicine ; Medicine and Health Sciences ; Meta-analysis ; Patients ; Physical Sciences ; Professionals ; Prognosis ; Research and Analysis Methods ; Risk analysis ; Risk factors ; Stroke ; Studies ; Surgery ; Systematic review ; Time Factors</subject><ispartof>PloS one, 2014-05, Vol.9 (5), p.e96743-e96743</ispartof><rights>COPYRIGHT 2014 Public Library of Science</rights><rights>2014 Specogna et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2014 Specogna et al 2014 Specogna et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-4448e559f4296338004ee9ef2f34b1a5c091915f6b159cc53c3b520dbef571853</citedby><cites>FETCH-LOGICAL-c692t-4448e559f4296338004ee9ef2f34b1a5c091915f6b159cc53c3b520dbef571853</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014549/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014549/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,2098,2917,23853,27911,27912,53778,53780,79355,79356</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24809990$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Ai, Jinglu</contributor><creatorcontrib>Specogna, Adrian V</creatorcontrib><creatorcontrib>Turin, Tanvir C</creatorcontrib><creatorcontrib>Patten, Scott B</creatorcontrib><creatorcontrib>Hill, Michael D</creatorcontrib><title>Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.
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.
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.
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.</description><subject>Analysis</subject><subject>Anticoagulants</subject><subject>Bleeding</subject><subject>Blood pressure</subject><subject>Cerebral Hemorrhage - diagnosis</subject><subject>Clinical trials</subject><subject>Disability</subject><subject>Fibrin</subject><subject>Fibrinogen</subject><subject>Global health</subject><subject>Glucose</subject><subject>Health care</subject><subject>Health sciences</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Intervention</subject><subject>Intracerebral hemorrhage</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Patients</subject><subject>Physical Sciences</subject><subject>Professionals</subject><subject>Prognosis</subject><subject>Research and Analysis Methods</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Stroke</subject><subject>Studies</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>Time Factors</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk01v1DAQhiMEoqXwDxBYQkJw2MWf2ZgDUlVRWKlSJb6u1sSZ7LpK4tb2tuyB_47T3Va7qAeUQxznmXdmXnuK4iWjUyZm7MOFX4UBuumlH3BKqS5nUjwqDpkWfFJyKh7vrA-KZzFeUKpEVZZPiwMuK6q1pofFn1OwyYdIIEZvHSRsyI1LS4IQujVpMGFwPkByfiDQ5i8Sc8YEA_pVJG5IASwGrAN0ZIm9D2EJC_xIgMR1TNjnSEsCXju8ITA0pMcEE8iFr6OLz4snLXQRX2zfR8XP088_Tr5Ozs6_zE-Ozya21DxNpJQVKqVbyXUpREWpRNTY8lbImoGyVDPNVFvWTGlrlbCiVpw2NbZqxioljorXG93LzkezdS4apjif8VJokYn5hmg8XJjL4HoIa-PBmdsNHxYGQm6lQ6OwtNC0TTNTQlLV6kpyyktez_IaKM9an7bZVnWPjcXRpG5PdP_P4JZm4a-NpEwqqbPAu61A8FcrjMn0Llrsuo3rY905c8Vz6UfFm3_Qh7vbUgvIDbih9eOxjaLmWLKqFFLeUtMHqPw02Dubr1nr8v5ewPu9gMwk_J0WsIrRzL9_-3_2_Nc--3aHXSJ0aRl9txovYdwH5Qa0wccYsL03mVEzTsmdG2acErOdkhz2aveA7oPuxkL8BQEsDnI</recordid><startdate>20140508</startdate><enddate>20140508</enddate><creator>Specogna, Adrian V</creator><creator>Turin, Tanvir C</creator><creator>Patten, Scott B</creator><creator>Hill, Michael D</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20140508</creationdate><title>Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis</title><author>Specogna, Adrian V ; Turin, Tanvir C ; Patten, Scott B ; Hill, Michael D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-4448e559f4296338004ee9ef2f34b1a5c091915f6b159cc53c3b520dbef571853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Analysis</topic><topic>Anticoagulants</topic><topic>Bleeding</topic><topic>Blood pressure</topic><topic>Cerebral Hemorrhage - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Specogna, Adrian V</au><au>Turin, Tanvir C</au><au>Patten, Scott B</au><au>Hill, Michael D</au><au>Ai, Jinglu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2014-05-08</date><risdate>2014</risdate><volume>9</volume><issue>5</issue><spage>e96743</spage><epage>e96743</epage><pages>e96743-e96743</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.
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.
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.
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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24809990</pmid><doi>10.1371/journal.pone.0096743</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis Anticoagulants Bleeding Blood pressure Cerebral Hemorrhage - diagnosis Clinical trials Disability Fibrin Fibrinogen Global health Glucose Health care Health sciences Hemorrhage Humans Hypertension Intervention Intracerebral hemorrhage Medical prognosis Medicine Medicine and Health Sciences Meta-analysis Patients Physical Sciences Professionals Prognosis Research and Analysis Methods Risk analysis Risk factors Stroke Studies Surgery Systematic review Time Factors |
| title | Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis |
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