Yu Zhiyuan, Zheng Jun, Guo Rui, Ma Lu, Li Mou, Wang Xiaoze, Lin Sen, Li Hao, You Chao
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Clin Neurol Neurosurg. 2017 Dec;163:84-89. doi: 10.1016/j.clineuro.2017.10.017. Epub 2017 Oct 20.
Hematoma expansion is independently associated with poor outcome in intracerebral hemorrhage (ICH). Blend sign is a simple predictor for hematoma expansion on non-contrast computed tomography. However, its accuracy for predicting hematoma expansion is inconsistent in previous studies. This meta-analysis is aimed to systematically assess the performance of blend sign in predicting hematoma expansion in ICH.
A systematic literature search was conducted. Original studies about predictive accuracy of blend sign for hematoma expansion in ICH were included. Pooled sensitivity, specificity, positive and negative likelihood ratios were calculated. Summary receiver operating characteristics curve was constructed. Publication bias was assessed by Deeks' funnel plot asymmetry test.
A total of 5 studies with 2248 patients were included in this meta-analysis. The pooled sensitivity, specificity, positive and negative likelihood ratios of blend sign for predicting hematoma expansion were 0.28, 0.92, 3.4 and 0.78, respectively. The area under the curve (AUC) was 0.85. No significant publication bias was found.
This meta-analysis demonstrates that blend sign is a useful predictor with high specificity for hematoma expansion in ICH. Further studies with larger sample size are still necessary to verify the accuracy of blend sign for predicting hematoma expansion.
血肿扩大与脑出血（ICH）预后不良独立相关。混合征是在非增强计算机断层扫描上预测血肿扩大的一个简单指标。然而，其预测血肿扩大的准确性在以往研究中并不一致。本荟萃分析旨在系统评估混合征在预测ICH血肿扩大中的表现。
进行了系统的文献检索。纳入了关于混合征对ICH血肿扩大预测准确性的原始研究。计算合并敏感度、特异度、阳性和阴性似然比。构建汇总受试者工作特征曲线。通过Deeks漏斗图不对称性检验评估发表偏倚。
本荟萃分析共纳入5项研究，涉及2248例患者。混合征预测血肿扩大的合并敏感度、特异度、阳性和阴性似然比分别为0.28、0.92、3.4和0.78。曲线下面积（AUC）为0.85。未发现明显的发表偏倚。
本荟萃分析表明，混合征是预测ICH血肿扩大的一个有用指标，具有较高的特异度。仍需要进一步开展更大样本量的研究来验证混合征预测血肿扩大的准确性。
