Intracranial Bleeding in Deep Brain Stimulation Surgery: A Systematic Review and Meta-Analysis.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Jakov Tiefenbach, Leonardo Favi Bocca, Olivia Hogue, Neil Nero, Kenneth B Baker, Andre G Machado
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Abstract

Background: Deep brain stimulation (DBS) is a neurosurgical treatment used for the treatment of movement disorders. Surgical and perioperative complications, although infrequent, can result in clinically significant neurological impairment.

Objectives: In this study, we evaluated the incidence and risk factors of intracranial bleeding in DBS surgery.

Method: Medline, EMBASE, and Cochrane were screened in line with PRISMA 2020 guidelines to capture studies reporting on the incidence of hemorrhagic events in DBS. After removing duplicates, the search yielded 1,510 papers. Abstracts were evaluated by two independent reviewers for relevance. A total of 386 abstracts progressed to the full-text screen and were assessed against eligibility criteria. A total of 151 studies met the criteria and were included in the analysis. Any disagreement between the reviewers was resolved by consensus. Relevant data points were extracted and analyzed in OpenMeta [Analyst] software.

Results: The incidence of intracranial bleeding was 2.5% (95% CI: 2.2-2.8%) per each patient and 1.4% (95% CI: 1.2-1.6%) per each implanted lead. There was no statistically significant difference across implantation targets and clinical indications. Patients who developed an intracranial bleed were on average 5 years older (95% CI: 1.26-13.19), but no difference was observed between the genders (p = 0.891). A nonsignificant trend was observed for a higher risk of bleeding in patients with hypertension (OR: 2.99, 95% CI: 0.97-9.19) (p = 0.056). The use of microelectrode recording did not affect the rate of bleeding (p = 0.79).

Conclusions: In this review, we find that the rate of bleeding per each implanted lead was 1.4% and that older patients had a higher risk of hemorrhage.

深部脑刺激手术颅内出血:系统回顾和荟萃分析。
背景:脑深部刺激(DBS)是一种用于治疗运动障碍的神经外科治疗方法。手术和围手术期并发症虽然不常见,但可导致临床上显著的神经功能损害。目的:在本研究中,我们评估DBS手术颅内出血的发生率和危险因素。方法:根据PRISMA 2020指南对Medline、EMBASE和Cochrane进行筛选,以获取关于DBS出血事件发生率的研究报告。在去掉重复的部分后,搜索得到了1510篇论文。摘要由两名独立审稿人评估相关性。共有386篇摘要进入全文屏幕,并根据资格标准进行评估。共有151项研究符合标准并被纳入分析。审稿人之间的任何分歧都以协商一致的方式解决。在OpenMeta [Analyst]软件中提取相关数据点并进行分析。结果:每例患者颅内出血发生率为2.5% (95% CI: 2.2-2.8%),每根植入导线颅内出血发生率为1.4% (95% CI: 1.2-1.6%)。植入目标和临床指征之间无统计学差异。发生颅内出血的患者平均年龄大5岁(95% CI: 1.26-13.19),但性别间无差异(p = 0.891)。高血压患者出血风险增加的趋势不显著(OR: 2.99, 95% CI: 0.97-9.19) (p = 0.056)。微电极记录的使用对出血率无影响(p = 0.79)。结论:在本综述中,我们发现每个植入铅的出血率为1.4%,老年患者出血的风险更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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