Department of Neurosurgery, The First People's Hospital of Yongkang City, Yongkang, China.
Acta Neurochir (Wien). 2024 Jul 10;166(1):291. doi: 10.1007/s00701-024-06174-z.
The most deadly type of spontaneous intracerebral hemorrhage is spontaneous cerebellar hemorrhage (SCH). The purpose of this meta-analysis was to investigate risk factors for prognosis in SCH patients to provide a basis for taking preventive and therapeutic measures.
Seven electronic databases were searched from inception to May 2023 for randomized controlled trial, cohort study, case control study and cross-sectional study on prognosis of spontaneous cerebellar hemorrhage. The quality of the selected studies were assessed by the American Agency for Healthcare Research and Quality (AHRQ). To assess the impact of the included risk factors on the prognosis of spontaneous cerebellar hemorrhage, combined odds ratios (ORs) with matching 95% confidence intervals (CIs) were combined.
Eight studies were included, including 539 participants. And a total of 31 potentially associated risk factors were identified. Ultimately, 6 risk factors were included in the meta-analysis after assessing. The factors supported by moderate evidence include the hydrocephalus (OR = 4.3, 95% CI: 2.33 to 7.91) and drug-induced coagulopathy (OR = 2.74, 95% CI: 1.23 to 6.09). The factors supported by limited evidence include the intraventricular bleeding(OR = 1.86, 95% CI: 1.13 to 3.07) and hematoma size>3 cm(OR = 3.18, 95% CI: 1.87 to 5.39). Meta-analysis revealed no association between hypertension, diabetes mellitus and SCH prognosis.
The current meta-analysis revealed obvious risk factors for prognosis in spontaneous cerebellar hemorrhage patients, including hydrocephalus, drug-induced coagulopathy, intraventricular bleeding and hematoma size>3 cm.
自发性脑内出血中最致命的类型是自发性小脑出血(SCH)。本荟萃分析的目的是研究 SCH 患者预后的危险因素,为采取预防和治疗措施提供依据。
从建库至 2023 年 5 月,检索了七个电子数据库,以获取关于自发性小脑出血预后的随机对照试验、队列研究、病例对照研究和横断面研究。使用美国医疗保健研究与质量局(AHRQ)评估所选研究的质量。为了评估纳入的危险因素对自发性小脑出血预后的影响,将具有匹配 95%置信区间(CI)的合并优势比(OR)进行了合并。
纳入了 8 项研究,共 539 名参与者。总共确定了 31 个潜在相关的危险因素。最终,经过评估,有 6 个危险因素纳入了荟萃分析。有中度证据支持的因素包括脑积水(OR=4.3,95%CI:2.33 至 7.91)和药物诱导的凝血障碍(OR=2.74,95%CI:1.23 至 6.09)。有有限证据支持的因素包括脑室内出血(OR=1.86,95%CI:1.13 至 3.07)和血肿大小>3cm(OR=3.18,95%CI:1.87 至 5.39)。荟萃分析显示高血压和糖尿病与 SCH 预后之间无关联。
本荟萃分析揭示了自发性小脑出血患者预后的明显危险因素,包括脑积水、药物诱导的凝血障碍、脑室内出血和血肿大小>3cm。