Danfeng Zhang1, Jigang Chen1, Jiaming Guo2, Ying Jiang1, Yan Dong3, Benjamin Ping-Chi Chen4, Junyu Wang5, Lijun Hou6. 1. Department of Neurosurgery, Shanghai Institute of Neurosurgery, PLA Institute of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China. 2. Department of Radiation Medicine, Faculty of Naval Medicine, Second Military Medical University, Shanghai, China. 3. Department of Neurosurgery, Shanghai Institute of Neurosurgery, PLA Institute of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China. Electronic address: smmudongyan@163.com. 4. Division of Molecular Radiation Biology, Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA. 5. Department of Neurosurgery, Shanghai Institute of Neurosurgery, PLA Institute of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China. Electronic address: jerome2008@163.com. 6. Department of Neurosurgery, Shanghai Institute of Neurosurgery, PLA Institute of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China. Electronic address: lijunhoucz@126.com.
Abstract
BACKGROUND: Hematoma expansion (HE) is independently associated with clinical outcome after intracerebral hemorrhage (ICH). Hematoma heterogeneity on noncontrast computed tomography (NCCT) is reportedly predictive of HE, but conclusions are inconsistent. We sought to clarify the relationship between hematoma heterogeneity and HE by pooling the pertinent publications. METHODS: The Cochrane Library, PubMed, and Embase were searched for related studies examining the correlation of HE with hematoma heterogeneity, and the secondary endpoint was defined as poor outcome. The effect size was odds ratio (OR) with its 95% confidence interval (CI). Results from each study were pooled using a random-effects model. RESULTS: Ten studies were included with a total of 5931 patients and 675 HEs. We detected a statistically significant association between NCCT heterogeneity and HE (OR, 2.55; 95% CI, 1.82-3.56; P < 0.001), while the correlation with poor outcome was nonsignificant (OR, 1.20; 95% CI, 0.94-1.54, P = 0.15). CONCLUSIONS: Our findings indicate that hematoma heterogeneity on NCCT is positively associated with an increased risk of HE. The relationship between hematoma heterogeneity and poor outcome merits evaluation in further prospective studies.
BACKGROUND:Hematoma expansion (HE) is independently associated with clinical outcome after intracerebral hemorrhage (ICH). Hematoma heterogeneity on noncontrast computed tomography (NCCT) is reportedly predictive of HE, but conclusions are inconsistent. We sought to clarify the relationship between hematoma heterogeneity and HE by pooling the pertinent publications. METHODS: The Cochrane Library, PubMed, and Embase were searched for related studies examining the correlation of HE with hematoma heterogeneity, and the secondary endpoint was defined as poor outcome. The effect size was odds ratio (OR) with its 95% confidence interval (CI). Results from each study were pooled using a random-effects model. RESULTS: Ten studies were included with a total of 5931 patients and 675 HEs. We detected a statistically significant association between NCCT heterogeneity and HE (OR, 2.55; 95% CI, 1.82-3.56; P < 0.001), while the correlation with poor outcome was nonsignificant (OR, 1.20; 95% CI, 0.94-1.54, P = 0.15). CONCLUSIONS: Our findings indicate that hematoma heterogeneity on NCCT is positively associated with an increased risk of HE. The relationship between hematoma heterogeneity and poor outcome merits evaluation in further prospective studies.
Authors: Muhammad E Haque; Seth B Boren; Octavio D Arevalo; Reshmi Gupta; Sarah George; Maria A Parekh; Xiurong Zhao; Jaraslow Aronowski; Sean I Savitz Journal: Front Neurol Date: 2021-11-30 Impact factor: 4.003