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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Prognostic Value of Clot Burden Score in Acute Ischemic Stroke after Reperfusion Therapies: A Systematic Review and Meta-Analysis
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Prognostic Value of Clot Burden Score in Acute Ischemic Stroke after Reperfusion Therapies: A Systematic Review and Meta-Analysis

机译：再灌注治疗后急性缺血性卒中凝块负荷评分的预后价值：系统评价与荟萃分析

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摘要

Background and Aim: Clot burden score (CBS) was designed to weight the thrombus status in cerebral anterior circulation. We performed a systematic review and metaanalysis to investigate the prognostic value of CBS in acute ischemic stroke (AIS) patients undergoing reperfusion therapies. Methods: We searched relevant databases for eligible articles reporting CBS in AIS patients. The effect sizes of good functional outcome, recanalization, or hemorrhagic transformation (HT) were pooled with random-/fixed-effect models. Sensitivity analyses and heterogeneity tests were performed. Results: Fifteen eligible studies enrolling 3302 AIS patients undergoing reperfusion therapies were included. AIS patients with per 1-point increase CBS were associated with good functional outcome (pooled odds ratio [OR]: 1.15, 95% confidence interval [CI]: 1.09-1.20) and high rate of recanalization (pooled OR: 1.27, 95% CI: 1.14-1.40). Results from categorical groups indicated high CBS at baseline was associated with higher likelihood of good functional outcome (pooled OR: 1.59, 95% CI: 1.30-1.94) and superior recanalization rates (pooled OR: 2.53, 95% CI: 1.79-3.57). Further stratified analyses showed in intravenous thrombolysis (IVT) alone group, increasing CBS was associated with good functional outcome (continuous pooled OR: 1.18, 95% CI: 1.10-1.27; categorical pooled OR: 3.38, 95% CI: 2.01-5.69) or recanalization (categorical pooled OR: 4.13, 95% CI: 2.00-8.51), but not in endovascular therapy alone group. No significant association was found between CBS and HT. Conclusions: CBS could be a predictor for AIS after reperfusion therapies in functional outcome and successful recanalization particularly in patients receiving IVT alone; while CBS might not be a predictor for HT.
机译：背景和目的：凝块负荷评分（CBS）设计为脑前循环中的血栓状态重量。我们进行了系统审查和元分析，以探讨CBS在接受再灌注疗法的急性缺血性卒中（AIS）患者中的CBS的预后价值。方法：我们在AIS患者中搜索了符合条件的文章的相关数据库。利用随机/固定效果模型合并良好功能结果，重新化或出血转化（HT）的效果大小。进行敏感性分析和异质性测试。结果：15302名符合3302 AIS患者的十五项符合条件的研究均包括接受再灌注疗法。 AIS患有每1点升高CBS的患者与良好的功能结果相关（合并的赔率比[或]：1.15,95％置信区间[CI]：1.09-1.20）和重算法（汇集或：1.27，95％） CI：1.14-1.40）。分类基团的结果表明基线高CBS与良好功能结果的似况较高有关（汇集或：1.59,95％CI：1.30-1.94）和卓越的再生率（汇总或：2.53,95％CI：1.79-3.57） 。进一步的分层分析显示在静脉内溶栓（IVT）单独组中，增加CBS与良好的功能结果相关（连续合并或：1.18,95％CI：1.10-1.27;分类汇总或：3.38,95％CI：2.01-5.69）或重新化（分类汇总或：4.13,95％CI：2.00-8.51），但单独的血管内疗法不足。 CBS和HT之间没有发现任何重要关联。结论：CBS可以是功能性结果的再灌注治疗后AIS的预测因子，并且尤其是接受IVT的患者的成功重新化;虽然CBS可能不是HT的预测因素。

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