Pooled analysis suggests benefit of catheter-based hematoma removal for intracerebral hemorrhage.
Age Factors
Aged
Aged, 80 and over
Antihypertensive Agents
/ therapeutic use
Blood Pressure
Catheterization
Cerebral Hemorrhage
/ mortality
Clot Retraction
Female
Fibrinolytic Agents
/ therapeutic use
Hematoma
/ mortality
Hemostatics
/ therapeutic use
Humans
Male
Meta-Analysis as Topic
Middle Aged
Models, Statistical
Neuroprotective Agents
/ therapeutic use
Randomized Controlled Trials as Topic
Treatment Outcome
Journal
Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060
Informations de publication
Date de publication:
09 04 2019
09 04 2019
Historique:
received:
19
03
2018
accepted:
06
12
2018
pubmed:
22
3
2019
medline:
18
12
2019
entrez:
22
3
2019
Statut:
ppublish
Résumé
To develop models of outcome for intracerebral hemorrhage (ICH) to identify promising and futile interventions based on their early phase results without need for correction for baseline imbalances. We developed a pooled outcome model from the control arms of randomized control trials and tested different interventions against the model at comparable baseline conditions. Eligible clinical trials and large case series were identified from multiple library databases. Models based on baseline factors reported in the control arms were tested for the ability to predict functional outcome (modified Rankin Scale score) and mortality. Interventions were grouped into blood pressure control, fibrinolytic-assisted hematoma evacuation, hemostatic medications, and neuroprotective agents. Statistical intervals around the model were generated at the Fourteen control arms with 3,386 patients were used to develop 7 alternate models for functional outcome. The model incorporating baseline NIH Stroke Scale, age, and hematoma volume yielded the best fit (adjusted We successfully developed an outcome model for ICH that identified interventions destined to be negative while identifying a promising one. Such an approach may assist in prioritizing resources prior to multicenter trial.
Identifiants
pubmed: 30894441
pii: WNL.0000000000007269
doi: 10.1212/WNL.0000000000007269
pmc: PMC6511084
doi:
Substances chimiques
Antihypertensive Agents
0
Fibrinolytic Agents
0
Hemostatics
0
Neuroprotective Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1688-e1697Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2019 American Academy of Neurology.
Références
Stroke. 1999 Sep;30(9):1833-9
pubmed: 10471432
JAMA Neurol. 2017 Aug 1;74(8):950-960
pubmed: 28628707
J Stroke Cerebrovasc Dis. 2009 Nov-Dec;18(6):466-8
pubmed: 19900650
Stroke. 2012 Jun;43(6):1496-504
pubmed: 22511006
Neurology. 2007 Jun 12;68(24):2132-9
pubmed: 17562835
Lancet. 2016 Jun 25;387(10038):2605-2613
pubmed: 27178479
Stroke. 2013 Mar;44(3):635-41
pubmed: 23370203
Transl Stroke Res. 2015 Oct;6(5):384-9
pubmed: 25907620
Stroke. 2001 Apr;32(4):891-7
pubmed: 11283388
Lancet. 2013 Aug 3;382(9890):397-408
pubmed: 23726393
Stroke. 2007 Aug;38(8):2262-9
pubmed: 17569876
Stroke. 2016 Jan;47(1):44-52
pubmed: 26645254
PLoS One. 2013 Jul 05;8(7):e67754
pubmed: 23861800
N Engl J Med. 2013 Jun 20;368(25):2355-65
pubmed: 23713578
Stroke. 2005 May;36(5):1006-10
pubmed: 15831831
Neurol India. 2012 Jan-Feb;60(1):40-4
pubmed: 22406778
Lancet Neurol. 2016 Nov;15(12):1228-1237
pubmed: 27751554
Stroke. 2009 May;40(5):1803-10
pubmed: 19286598
N Engl J Med. 2008 May 15;358(20):2127-37
pubmed: 18480205
Stroke. 2001 Apr;32(4):909-16
pubmed: 11283391
N Engl J Med. 2005 Feb 24;352(8):777-85
pubmed: 15728810
J Stroke Cerebrovasc Dis. 2014 Jul;23(6):1312-8
pubmed: 24680087
Lancet Neurol. 2008 May;7(5):391-9
pubmed: 18396107
Transl Stroke Res. 2015 Dec;6(6):451-7
pubmed: 26385545
J Neurol Neurosurg Psychiatry. 2006 May;77(5):601-5
pubmed: 16354736
Lancet. 2005 Jan 29-Feb 4;365(9457):387-97
pubmed: 15680453
Stroke. 1992 Aug;23(8):1084-9
pubmed: 1636182
Neurology. 2015 Jul 21;85(3):274-83
pubmed: 26109712
Stroke. 2011 Nov;42(11):3067-74
pubmed: 21868742
Neurology. 1998 Nov;51(5):1359-63
pubmed: 9818860
Stroke. 2016 Nov;47(11):2749-2755
pubmed: 27758940
N Engl J Med. 2001 May 10;344(19):1450-60
pubmed: 11346811
Crit Care Med. 2010 Feb;38(2):637-48
pubmed: 19770736
Stroke. 2013 Jun;44(6 Suppl 1):S70-3
pubmed: 23709737
Stroke. 2008 Aug;39(8):2304-9
pubmed: 18556582
Cerebrovasc Dis. 2006;21(5-6):380-5
pubmed: 16490951
Eur J Neurol. 2013 Aug;20(8):1161-9
pubmed: 23551657
N Engl J Med. 2016 Sep 15;375(11):1033-43
pubmed: 27276234
J Neurol Sci. 2017 Aug 15;379:103-108
pubmed: 28716217
Stroke. 2003 Apr;34(4):968-74
pubmed: 12649510
J Neurol Neurosurg Psychiatry. 2005 Jun;76(6):839-44
pubmed: 15897508
Lancet. 2019 Mar 9;393(10175):1021-1032
pubmed: 30739747