Zhiyuan Yu1, Jun Zheng1, Rui Guo1, Lu Ma1, Mou Li2, Xiaoze Wang2, Sen Lin1, Hao Li1, Chao You3. 1. Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China. 2. Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China. 3. Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address: youchaowchscu@163.com.
Abstract
OBJECTIVES: Hematoma expansion is independently associated with poor outcome in intracerebral hemorrhage (ICH). Blend sign is a simple predictor for hematoma expansion on non-contrast computed tomography. However, its accuracy for predicting hematoma expansion is inconsistent in previous studies. This meta-analysis is aimed to systematically assess the performance of blend sign in predicting hematoma expansion in ICH. MATERIAL AND METHODS: A systematic literature search was conducted. Original studies about predictive accuracy of blend sign for hematoma expansion in ICH were included. Pooled sensitivity, specificity, positive and negative likelihood ratios were calculated. Summary receiver operating characteristics curve was constructed. Publication bias was assessed by Deeks' funnel plot asymmetry test. RESULTS: A total of 5 studies with 2248 patients were included in this meta-analysis. The pooled sensitivity, specificity, positive and negative likelihood ratios of blend sign for predicting hematoma expansion were 0.28, 0.92, 3.4 and 0.78, respectively. The area under the curve (AUC) was 0.85. No significant publication bias was found. CONCLUSION: This meta-analysis demonstrates that blend sign is a useful predictor with high specificity for hematoma expansion in ICH. Further studies with larger sample size are still necessary to verify the accuracy of blend sign for predicting hematoma expansion.
OBJECTIVES:Hematoma expansion is independently associated with poor outcome in intracerebral hemorrhage (ICH). Blend sign is a simple predictor for hematoma expansion on non-contrast computed tomography. However, its accuracy for predicting hematoma expansion is inconsistent in previous studies. This meta-analysis is aimed to systematically assess the performance of blend sign in predicting hematoma expansion in ICH. MATERIAL AND METHODS: A systematic literature search was conducted. Original studies about predictive accuracy of blend sign for hematoma expansion in ICH were included. Pooled sensitivity, specificity, positive and negative likelihood ratios were calculated. Summary receiver operating characteristics curve was constructed. Publication bias was assessed by Deeks' funnel plot asymmetry test. RESULTS: A total of 5 studies with 2248 patients were included in this meta-analysis. The pooled sensitivity, specificity, positive and negative likelihood ratios of blend sign for predicting hematoma expansion were 0.28, 0.92, 3.4 and 0.78, respectively. The area under the curve (AUC) was 0.85. No significant publication bias was found. CONCLUSION: This meta-analysis demonstrates that blend sign is a useful predictor with high specificity for hematoma expansion in ICH. Further studies with larger sample size are still necessary to verify the accuracy of blend sign for predicting hematoma expansion.
Authors: Zhe Kang Law; Azlinawati Ali; Kailash Krishnan; Adam Bischoff; Jason P Appleton; Polly Scutt; Lisa Woodhouse; Stefan Pszczolkowski; Lesley A Cala; Robert A Dineen; Timothy J England; Serefnur Ozturk; Christine Roffe; Daniel Bereczki; Alfonso Ciccone; Hanne Christensen; Christian Ovesen; Philip M Bath; Nikola Sprigg Journal: Stroke Date: 2019-11-18 Impact factor: 7.914