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Infarct volume and outcome of cerebral ischaemia, a systematic review and meta-analysis
1Department of Neurosurgery, The Second Affiliated Hospital of Shandong First Medical University, Taian, China.
Insights
Infarct volume (IV) significantly predicts poor outcomes in ischemic stroke patients. A meta-analysis found IV is a reliable prognostic criterion, with specific cutoffs aiding outcome prediction.
Area of Science:
- Neurology
- Radiology
- Clinical Research
Background:
- Numerous studies have explored infarct volume (IV) as a predictor of outcomes in ischemic stroke.
- However, a systematic review synthesizing these findings was lacking.
Purpose of the Study:
- To systematically review and meta-analyze studies assessing infarct volume (IV) as a prognostic criterion for patients with cerebral ischemia.
- To evaluate the accuracy of IV in predicting functional outcomes.
Main Methods:
- A systematic search of PubMed, Scopus, Embase, and Cochrane library databases was conducted.
- Nine studies reporting infarct volume and prognostic outcomes were included.
- Meta-analysis focused on the 90-day modified Rankin Scale (mRS) score, assessing sensitivity, specificity, and publication bias.
Main Results:
- A significant association was found between infarct volume (IV) and unfavorable functional outcomes (mRS 3-6) (OR=0.80; 95% CI: 0.74-0.86 per 10 mL).
- The meta-analysis indicated high heterogeneity among studies (I² = 98.1%).
- An infarct volume cutoff between 20 and 50 mL demonstrated the best sensitivity and specificity for predicting poor clinical outcomes.
Conclusions:
- Infarct volume (IV) is significantly associated with unfavorable functional outcomes in patients with ischemic stroke.
- IV serves as a valuable prognostic criterion in managing patients with cerebral ischemia.
Background:
Multiple studies have evaluated the accuracy of infarct volume (IV) as a predictor of outcome in patients with ischaemic stroke; however, no study has systematically reviewed the results of these studies.
Aim:
This systematic review and meta-analysis aim to sum up the results of the studies evaluating IV as the prognostic criteria for patients with cerebral ischaemia.
Methods:
Human studies that reported the infarction volume and any prognostic outcome in patients with ischaemic stroke were collected from PubMed, Scopus, Embase and Cochrane library databases. Newcastle-Ottawa Quality Assessment Checklist was applied to evaluate the quality of the included articles. 90-day modified Rankin Scale (mRS) score was used as a meta-analysis outcome. The area under the curve, sensitivity and specificity among included studies was evaluated. The heterogeneity of the studies was assessed by Cochran test Egger and Begg test was used for assessing publication bias.
Results:
Among the included studies, nine studies assessed the association between IV and outcome (90-day mRS score). The results of the meta-analysis revealed a significant association between IV with the unfavourable functional outcome (mRS score of 3-6) (OR = 0.80; 95% CI: 0.74-0.86 per 10 mL, P < .001; I2 = 98.1%, P < .001). The infarction volume cut of point between 20 and 50 mL showed the best sensitivity and specificity for the prediction of poor clinical outcomes in patients with ischaemic stroke.
Conclusion:
The results of the meta-analysis revealed a significant association between IV and unfavourable functional outcomes in patients with ischaemic stroke.
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