Comparison of surgical strategies in patients with spontaneous intracerebral haemorrhage: a protocol for a network meta-analysis

The prognostic value of red blood cell distribution width for mortality in intracranial hemorrhage: A systematic review and meta-analysis

BACKGROUND

Some studies have reported conflicting results regarding the prognostic value of red blood cell distribution width (RDW) for patients with intracranial hemorrhage (ICH). This meta-analysis aims to investigate the association between RDW and all-cause mortality in ICH.

METHODS

We systematically searched the following databases, including PubMed, EMBASE, Cochrane library, and Web of Science, for all studies assessing the prognostic value of mortality in patients with ICH from inception to December 2023. We calculated pooled odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

A total of 7 studies evaluated the association of RDW and all-cause mortality. A higher RDW levels were significantly associated with all-cause mortality (OR = 1.52; 95% CI = 1.22 to 1.89; P = .0002; I2 = 76%).

CONCLUSION

Therefore, RDW is a valuable prognostic marker for the risk of all-cause mortality in patients with intracranial hemorrhage.

Comparison of surgical strategies in patients with chronic subdural haematoma: a protocol for a network meta-analysis

INTRODUCTION

Chronic subdural haematoma (CSDH) is one of the most common neurosurgical emergencies, especially in the elderly population. Surgery is the mainstay of treatment for CSDH. Some studies have suggested that some specific surgical strategies can have potential benefits for patients with CSDH; however, the best surgical method is still controversial. For a better understanding of surgical treatment for these patients, it is necessary to conduct a network meta-analysis to comprehensively compare the effects of medical treatment and different surgical methods.

METHODS AND ANALYSIS

This protocol has been reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Related studies published up to April 2023 will be searched in the following databases: PubMed, Embase, Scopus, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, VIP and Wanfang. Randomised controlled trials and non-randomised prospective studies comparing at least two different interventions for patients with CSDH will be included. Quality assessment will be conducted using Cochrane Collaboration's tool or the Newcastle-Ottawa Scale based on study design. The primary outcome will be the recurrence rates, and the secondary outcome will be the functional outcome at the end of follow-up. Pairwise and network meta-analyses will be conducted using STATA V.14 (StataCorp, College Station, Texas, USA). Mean ranks and the surface under the cumulative ranking curve will be used to evaluate each intervention. Statistical inconsistency assessment, subgroup analysis, sensitivity analysis and publication bias assessment will be performed.

ETHICS AND DISSEMINATION

Ethics approval is not necessary because this study will be based on publications. The results of this study will be published in a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

CRD42022376829.

Treatment strategies for asymptomatic carotid artery stenosis in the era of lipid-lowering drugs: protocol for a systematic review and network meta-analysis

INTRODUCTION

Carotid endarterectomy (CEA), carotid artery stenting (CAS) and best medical therapy (BMT) are the major treatments used for significant asymptomatic carotid artery stenosis (ACAS, ≥50%). However, the widespread use of lipid-lowering drugs in this century has improved BMT outcomes. This study aims to compare the treatment efficacy of current BMT, CEA+BMT and CAS+BMT in patients with significant ACAS.

METHODS AND ANALYSIS

This protocol was designed based on the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Publication time for studies will be set from 1 January 2000 to 1 June 2020. We will search three databases: PubMed, EMBASE and The Cochrane Library. Suitable randomised controlled studies will be screened. The primary outcomes will include short-term and long-term mortality, stroke and myocardial infarction. OR and HR for dichotomous data and time-to-event data with 95% CIs will be calculated. Treatment effects among different therapies will be ranked according to the surface under the cumulative ranking curve and mean rank. A comprehensive evaluation of the risk of bias, heterogeneity and transitivity will be performed before data synthesis. Consistency and evidence quality will also be assessed.

ETHICS AND DISSEMINATION

There will be no need for ethics approval as this systematic review is a summary and analysis of existing literature. Final results may be presented in international conferences or a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

CRD42019138942.