成人体内脑脊液分流术总生存率。根据重建的 Kaplan-Meier 数据对受限平均存活时间进行荟萃分析。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-01-01 DOI:10.1016/j.wneu.2024.10.057

Charles Champeaux Depond , Roch Giorgi , Vincent Jecko , Philippe Metellus

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引用次数: 0

摘要

目的：评估成人脑脊液内分流术（ICSFS）的总生存率（OS）：评估成人体内脑脊液分流术（ICSFS）的总生存率（OS）：方法：检索 2000 年至 2023 年的 Medline 数据库，以确定报告 ICSFS OS 的研究。仅纳入通过 Kaplan-Meier (KM) OS 曲线报告成人 ICSFS OS 的文章。从 KM 曲线中提取数字数据，然后进行重构，以估算 3、6、9、12、18、24、36、48 和 60 个月的限制性平均生存时间（RMST）。ICSFS的RMST及其在每个相关时间的标准误差（SE）被用作汇总指标和各研究的主要结果。为考虑研究间异质性的影响，采用随机效应模型对 RMST 进行汇总：在筛选出的 421 项研究中，只有 6 项纳入了荟萃分析。计算出的 3、6、12、18、24、36、48 和 60 个月的 ICSFS OS 分别为 92.4%，95%CI[89.6-95.2]；89.5%，95%CI[86.3-92.8]；87.5%，95%CI[83.9-91.1]；85.2%，95%CI[80.4-90.0]；83.4%，95%CI[79.0-87.9]；81.6%，95%CI[76.7-86.5]；78.8%，95%CI[72.9-84.6]；76.7%，95%CI[70.3-83.1]；74.5%，95%CI[67.8-81.1]。I2高达82.5%，95%CI[63.1-91.7]，表明存在明显的异质性。异质性检验的 Q=28.63 也具有显著性（p 值）：与人们的想象相反，目前评估成人 ICSFS OS 的研究很少。我们采用一种新技术对成人 ICSFS OS 进行了元分析。术后 3-6 个月内，ICSFS 的失败率最高。之后，随着时间的推移，风险会慢慢降低。5 年后，仍有不到四分之三的患者从未修改过 ICSFS 的原始功能。

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Adult Internal Cerebrospinal Fluid Shunt Overall Survival: A Meta-Analysis of Restricted Mean Survival Times from Reconstructed Kaplan-Meier Data

Objective

To assess the overall survival (OS) of internal cerebrospinal fluid shunt (ICSFS) in the adult population.

Methods

MEDLINE database was searched from 2000 to 2023 to identify studies reporting on ICSFS OS. Only articles reporting on adult ICSFS OS by a Kaplan-Meier (KM) OS curve were included. Numerical data were extracted from KM curves and were then reconstructed to estimate 3, 6, 9, 12, 18, 24, 36, 48, and 60 months restricted mean survival times (RMSTs). RMSTs of ICSFS and its SE at each time of interest were used as summary measure and primary outcome across studies. To account for the effect of between-study heterogeneity, RMSTs were pooled using a random effects model.

Results

Out of 421 screened studies, only 6 were included in the meta-analysis. Calculated ICSFS OS at 3, 6, 9, 12, 18, 24, 36, 48, and 60 months were 92.4% (95% CI, 89.6–95.2), 89.5% (95% CI, 86.3–92.8), 87.5% (95% CI, 83.9–91.1), 85.2% (95% CI, 80.4–90.0), 83.4% (95% CI, 79.0–87.9), 81.6% (95% CI, 76.7–86.5), 78.8% (95% CI, 72.9–84.6), 76.7% (95% CI, 70.3–83.1), and 74.5% (95% CI, 67.8–81.1), respectively. There was a significant heterogeneity as indicated by a high

I^{2}

value of 82.5% (95% CI, 63.1–91.7). Heterogeneity test of Q = 28.63 was also significant (P < 0.001).

Conclusions

On contrary to what one might think, there are few available studies assessing adult ICSFS OS. We used a novel technique to meta-analyze adult ICSFS OS. ICSFS failure rate is maximal within the 3 to 6 postoperative months. Afterward, the risk slowly decreases over time. At 5 years, less than three quarters of the patients still have a naïve functional ICSFS never revised.

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS