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| Meta-analysis of influencing factors for malignant cerebral edema in patients with acute cerebral infarction |
| YANG Wen LI Junzhuo LIU Guangwei▲ |
| Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China |
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Abstract Objective To systematically review the influencing factors of malignant cerebral edema in patients with acute cerebral infarction. Methods PubMed, Web of Science, EMbase, the Cochrane Library, CNKI, VIP, and Wanfang Data were searched to collect relevant literatures on influencing factors of malignant cerebral edema in patients with acute cerebral infarction. The retrieval period is from the inception to April 2021. Two reviewers independently screened literatures, extracted data, and assessed the quality of included studies, then, meta analysis was performed by RevMan 5.3 and Stata 15.0 software. Results A total of 18 literatures were included, including 66 792 patients. Meta-analysis results showed baseline National Institute of Health stroke scale (NIHSS) score (OR = 1.15, 95%CI: 1.15-1.16, P ＜ 0.01), history of atrial fibrillation (OR = 2.99, 95%CI:1.53-5.87, P ＜ 0.01), anterior cerebral artery involvement (OR = 5.53, 95%CI: 2.48-12.34, P ＜ 0.01), carotid artery occlusion (OR = 2.12, 95%CI:1.04-4.32, P = 0.04) were the risk factor for malignant cerebral edema after cerebral infarction. Sensitivity analysis showed that successful recanalization was a protective factor (OR = 0.36, 95%CI: 0.20-0.66, P ＜ 0.01), the stability was changed. Egger test results showed no publication bias (P ＞ 0.05). Conclusion Baseline NIHSS score, history of atrial fibrillation, anterior cerebral artery involvement, and carotid artery occlusion are risk factors for malignant cerebral edema after cerebral infarction, which should be paid attention to and timely take corresponding measures in clinical practice. The relationship between successful recanalization and malignant cerebral edema still needs further study.
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