Zhiyuan Yu1, Jun Zheng1, Lu Ma1, Hao Li1, Chao You1, Yan Jiang2. 1. Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China. 2. Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address: jiangyanhuaxi@sohu.com.
Abstract
OBJECTIVE: Delayed cerebral ischemia (DCI) happens in about 30% of patients with aneurysmal subarachnoid hemorrhage (SAH) and is related to higher mortality and disability. Some studies have shown cerebral autoregulation impairment can be a predictor of DCI in aneurysmal SAH. We conducted this meta-analysis to evaluate the predictive value of cerebral autoregulation impairment for DCI based on the current literature. METHODS: A systematic literature search was performed in PubMed and Embase. According to inclusion and exclusion criteria, 2 authors screened the records and extracted data from the included studies. Pooled sensitivity, specificity, and their 95% confidence intervals (CIs) were obtained. To investigate the overall accuracy, a summary receiver operating characteristic (SROC) curve was built and the area under SROC curve was calculated. Deeks' linear regression was used to assess the publication bias. All statistical analyses were performed with Stata 14.0. RESULTS: A total of 7 studies were finally included in this meta-analysis. The pooled sensitivity and specificity values of impaired cerebral autoregulation for DCI prediction were 0.79 (95% CI, 0.65-0.88) and 0.85 (95% CI, 0.615-0.96). Moreover, the area under the SROC curve of cerebral autoregulation impairment for DCI prediction was 0.87 (95% CI, 0.835-0.89). No obvious publication bias was found in Deeks' linear regression (P = 0.99). CONCLUSIONS: Cerebral autoregulation impairment can be a helpful predictor of DCI in aneurysmal SAH. Its accuracy for DCI prediction should be verified by more studies in the future.
OBJECTIVE:Delayed cerebral ischemia (DCI) happens in about 30% of patients with aneurysmal subarachnoid hemorrhage (SAH) and is related to higher mortality and disability. Some studies have shown cerebral autoregulation impairment can be a predictor of DCI in aneurysmalSAH. We conducted this meta-analysis to evaluate the predictive value of cerebral autoregulation impairment for DCI based on the current literature. METHODS: A systematic literature search was performed in PubMed and Embase. According to inclusion and exclusion criteria, 2 authors screened the records and extracted data from the included studies. Pooled sensitivity, specificity, and their 95% confidence intervals (CIs) were obtained. To investigate the overall accuracy, a summary receiver operating characteristic (SROC) curve was built and the area under SROC curve was calculated. Deeks' linear regression was used to assess the publication bias. All statistical analyses were performed with Stata 14.0. RESULTS: A total of 7 studies were finally included in this meta-analysis. The pooled sensitivity and specificity values of impaired cerebral autoregulation for DCI prediction were 0.79 (95% CI, 0.65-0.88) and 0.85 (95% CI, 0.615-0.96). Moreover, the area under the SROC curve of cerebral autoregulation impairment for DCI prediction was 0.87 (95% CI, 0.835-0.89). No obvious publication bias was found in Deeks' linear regression (P = 0.99). CONCLUSIONS: Cerebral autoregulation impairment can be a helpful predictor of DCI in aneurysmalSAH. Its accuracy for DCI prediction should be verified by more studies in the future.
Authors: Bryce Owen; Adarsh Vangala; Chanju Fritch; Ali A Alsarah; Tom Jones; Herbert Davis; C William Shuttleworth; Andrew P Carlson Journal: Stroke Date: 2022-02-24 Impact factor: 10.170
Authors: Andrew Silverman; Sreeja Kodali; Sumita Strander; Emily J Gilmore; Alexandra Kimmel; Anson Wang; Branden Cord; Guido Falcone; Ryan Hebert; Charles Matouk; Kevin N Sheth; Nils H Petersen Journal: Stroke Date: 2019-09-09 Impact factor: 7.914