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Risk factors ofhemorrhagictransformation inacute ischaemicstroke: A systematicreview andmeta-analysis Jiacheng SunChristina LamLauren J. Christie2023 год

Risk factors of hemorrhagic transformation in acute ischaemic stroke: A systematic review and meta-analysis

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Аннотация: Hemorrhagic transformation (HT) following reperfusion therapies for acute ischaemic stroke often predicts a poor prognosis. This systematic review and meta-analysis aims to identify risk factors for HT, and how these vary with hyperacute treatment [intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT)].Electronic databases PubMed and EMBASE were used to search relevant studies. Pooled odds ratio (OR) with 95% confidence interval (CI) were estimated.A total of 120 studies were included. Atrial fibrillation and NIHSS score were common predictors for any intracerebral hemorrhage (ICH) after reperfusion therapies (both IVT and EVT), while a hyperdense artery sign (OR = 2.605, 95% CI 1.212-5.599, I2 = 0.0%) and number of thrombectomy passes (OR = 1.151, 95% CI 1.041-1.272, I2 = 54.3%) were predictors of any ICH after IVT and EVT, respectively. Common predictors for symptomatic ICH (sICH) after reperfusion therapies were age and serum glucose level. Atrial fibrillation (OR = 3.867, 95% CI 1.970-7.591, I2 = 29.1%), NIHSS score (OR = 1.082, 95% CI 1.060-1.105, I2 = 54.5%) and onset-to-treatment time (OR = 1.003, 95% CI 1.001-1.005, I2 = 0.0%) were predictors of sICH after IVT. Alberta Stroke Program Early CT score (ASPECTS) (OR = 0.686, 95% CI 0.565-0.833, I2 =77.6%) and number of thrombectomy passes (OR = 1.374, 95% CI 1.012-1.866, I2 = 86.4%) were predictors of sICH after EVT.Several predictors of ICH were identified, which varied by treatment type. Studies based on larger and multi-center data sets should be prioritized to confirm the results.https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=268927, identifier: CRD42021268927.
Год издания: 2023
Авторы: Jiacheng Sun, Christina Lam, Lauren J. Christie, Christopher Blair, Xingjuan Li, Freda Werdiger, Qing Yang, Andrew Bivard, Longting Lin, Mark Parsons
Издательство: Frontiers Media
Источник: Frontiers in Neurology
Ключевые слова: Acute Ischemic Stroke Management, Intracerebral and Subarachnoid Hemorrhage Research, Venous Thromboembolism Diagnosis and Management
Другие ссылки: Frontiers in Neurology (PDF)
Frontiers in Neurology (HTML)
PubMed Central (HTML)
PubMed (HTML)