Stroke; a journal of cerebral circulation
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Letter Review Meta Analysis
Reliability of the modified Rankin Scale: a systematic review.
A perceived weakness of the modified Rankin Scale is potential for interobserver variability. We undertook a systematic review of modified Rankin Scale reliability studies. ⋯ There remains uncertainty regarding modified Rankin Scale reliability. Interobserver studies closest in design to large-scale clinical trials demonstrate potentially significant interobserver variability.
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Review Meta Analysis
Hyperglycemia and clinical outcome in aneurysmal subarachnoid hemorrhage: a meta-analysis.
Hyperglycemia may worsen outcome after aneurysmal subarachnoid hemorrhage. We performed a systematic review to investigate the relation between admission hyperglycemia and outcome after aneurysmal subarachnoid hemorrhage. ⋯ After aneurysmal subarachnoid hemorrhage, admission glucose levels are often high and hyperglycemia is associated with an increased risk of poor clinical outcome. A randomized clinical trial is warranted to study the potential benefit of glycemic control after aneurysmal subarachnoid hemorrhage.
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Meta Analysis
Impact of fever on outcome in patients with stroke and neurologic injury: a comprehensive meta-analysis.
Many studies associate fever with poor outcome in patients with neurological injury, but this relationship is blurred by divergence in populations and outcome measures. We sought to incorporate all recent scholarship addressing fever in brain-injured patients into a comprehensive meta-analysis to evaluate disparate clinical findings. ⋯ In the pooled analyses covering 14431 patients with stroke and other brain injuries, fever is consistently associated with worse outcomes across multiple outcome measures.
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Meta Analysis
Do statins improve outcomes and reduce the incidence of vasospasm after aneurysmal subarachnoid hemorrhage: a meta-analysis.
Subarachnoid hemorrhage (SAH) is a relatively rare cause of stroke with a high rate of morbidity and mortality, primarily due to the occurrence of delayed vasospasm. To date, many therapies have been proposed to help prevent vasospasm, but very few have been proven effective. The initiation of statin therapy after SAH may be effective in reducing the incidence of vasospasm; however, the only studies that have examined this effect have been small. This meta-analysis attempted to determine whether statins reduce morbidity and mortality after aneurysmal SAH. ⋯ Initiation of statin therapy after aneurysmal SAH significantly reduces the incidence of vasospasm, delayed ischemic deficits, and mortality. This is consistent with animal research and retrospective studies and supports the routine use of statins in the care of patients with aneurysmal SAH.
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Meta Analysis
Polymorphisms in platelet glycoprotein 1balpha and factor VII and risk of ischemic stroke: a meta-analysis.
Platelets and components of the coagulation cascade are known to be instrumental in the pathogenesis of arterial occlusive disorders. The aim of this meta-analysis is to test the hypothesis that genetic variation in the platelet glycoprotein 1balpha and Factor VII genes influence the occurrence of ischemic stroke. All genetic association studies that examined the R353Q (rs6046) polymorphism of the Factor VII gene and 2 polymorphisms of the platelet glycoprotein (1balpha) gene (Thr/Met rs6065 and Kozak sequence -5 C/T rs2243093) in relation to ischemic stroke were examined. ⋯ This analysis provides strong evidence that the Factor VII R353Q gene polymorphism is not associated with ischemic stroke, that the Thr/Met polymorphism of GP1balpha is associated with ischemic stroke in a dominant genetic model, and that the Kozak sequence polymorphism of GP1balpha may be close to another causative locus that is associated with ischemic stroke.