Francis Richard, Gregson Barbara A, Mendelow Alexander David, Rowan Elise
a Institute of Neuroscience, Neurosurgical Trials Group , Newcastle University , UK.
Br J Neurosurg. 2015;29(5):655-60. doi: 10.3109/02688697.2015.1054349. Epub 2015 Sep 28.
In undertaking international neurosurgical trials it is useful to understand international patient demographics and potential patient populations that study results will apply to. The STITCH(Trauma) trial included 59 centres from 20 countries, which were requested to screen all patients with traumatic intracerebral haemorrhage. This paper reviews these data.
Demographic, clinical and exclusion reason data were analysed. Comparisons were made between patients who were included in the trial and patients who were potentially eligible (but not included in the trial) and patients who were not potentially eligible.
Screening evidence was returned for 1735 patients, 11% of these may potentially have been eligible, of whom 52% were not included because consent could not be gained. By country, median age per centre ranged from 26 years (Egypt) to 67 years (Germany), median time from injury to screening ranged from 5 h (Germany and Nepal) to 16 h (India), median intracerebral haemorrhage (ICH) volume ranged from 5 ml (Germany) to 30 ml (China), the proportion of male patients ranged from 56% (Egypt) to 91% (Canada) and the proportion of patients with both pupils reactive ranged from 68% (China) to 98% (Nepal). The most common exclusion reasons were ICH volume < 10 ml (49%) and presence of subdural haemorrhage/extradural haemorrhage or SDH/EDH requiring surgery (20%).
Data presented here including international patient demographics and reasons for patient ineligibility will be useful for future traumatic ICH studies.
在开展国际神经外科试验时,了解国际患者人口统计学特征以及研究结果适用的潜在患者群体是很有帮助的。STITCH(创伤)试验纳入了来自20个国家的59个中心,要求对所有创伤性脑内出血患者进行筛查。本文对这些数据进行了回顾。
对人口统计学、临床和排除原因数据进行了分析。对纳入试验的患者、可能符合条件(但未纳入试验)的患者以及不符合条件的患者进行了比较。
共返回了1735例患者的筛查证据,其中11%可能符合条件,其中52%未被纳入是因为无法获得同意。按国家划分,每个中心的年龄中位数从26岁(埃及)到67岁(德国)不等,从受伤到筛查的时间中位数从5小时(德国和尼泊尔)到16小时(印度)不等,脑内出血(ICH)体积中位数从5毫升(德国)到30毫升(中国)不等,男性患者比例从56%(埃及)到91%(加拿大)不等,双侧瞳孔反应性患者比例从68%(中国)到98%(尼泊尔)不等。最常见的排除原因是ICH体积<10毫升(49%)以及存在需要手术的硬膜下出血/硬膜外出血或SDH/EDH(20%)。
本文提供的数据,包括国际患者人口统计学特征和患者不符合条件的原因,将对未来创伤性ICH研究有用。