دورية أكاديمية
Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data.
| العنوان: | Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data. |
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| المؤلفون: | Campbell, Bruce C V, van Zwam, Wim H, Goyal, Mayank, Menon, Bijoy K, Dippel, Diederik W J, Demchuk, Andrew M, Bracard, Serge, White, Philip, Dávalos, Antoni, Majoie, Charles B L M, van der Lugt, Aad, Ford, Gary A, de la Ossa, Natalia Pérez, Kelly, Michael, Bourcier, Romain, Donnan, Geoffrey A, Roos, Yvo B W E M, Bang, Oh Young, Nogueira, Raul G, Devlin, Thomas G, van den Berg, Lucie A, Clarençon, Frédéric, Burns, Paul, Carpenter, Jeffrey, Berkhemer, Olvert A, Yavagal, Dileep R, Pereira, Vitor Mendes, Ducrocq, Xavier, Dixit, Anand, Quesada, Helena, Epstein, Jonathan, Davis, Stephen M, Jansen, Olav, Rubiera, Marta, Urra, Xabier, Micard, Emilien, Lingsma, Hester F, Naggara, Olivier, Brown, Scott, Guillemin, Francis, Muir, Keith W, van Oostenbrugge, Robert J, Saver, Jeffrey L, Jovin, Tudor G, Hill, Michael D, Mitchell, Peter J, Baxter, Blaise W, MD |
| المصدر: | Department of Radiology & Diagnostic Medical Imaging |
| بيانات النشر: | LVHN Scholarly Works |
| سنة النشر: | 2018 |
| المجموعة: | Lehigh Valley Health Network: LVHN Scholarly Works |
| مصطلحات موضوعية: | Aged, 80 and over, Anesthesia, General, Brain Ischemia, Female, Humans, Male, Middle Aged, Outcome and Process Assessment, Health Care, Randomized Controlled Trials as Topic, Stroke, Thrombectomy, Department of Radiology and Diagnostic Medical Imaging, Diagnosis, Medicine and Health Sciences, Other Analytical, Diagnostic and Therapeutic Techniques and Equipment, Radiology |
| الوصف: | BACKGROUND: General anaesthesia (GA) during endovascular thrombectomy has been associated with worse patient outcomes in observational studies compared with patients treated without GA. We assessed functional outcome in ischaemic stroke patients with large vessel anterior circulation occlusion undergoing endovascular thrombectomy under GA, versus thrombectomy not under GA (with or without sedation) versus standard care (ie, no thrombectomy), stratified by the use of GA versus standard care. METHODS: For this meta-analysis, patient-level data were pooled from all patients included in randomised trials in PuMed published between Jan 1, 2010, and May 31, 2017, that compared endovascular thrombectomy predominantly done with stent retrievers with standard care in anterior circulation ischaemic stroke patients (HERMES Collaboration). The primary outcome was functional outcome assessed by ordinal analysis of the modified Rankin scale (mRS) at 90 days in the GA and non-GA subgroups of patients treated with endovascular therapy versus those patients treated with standard care, adjusted for baseline prognostic variables. To account for between-trial variance we used mixed-effects modelling with a random effect for trials incorporated in all models. Bias was assessed using the Cochrane method. The meta-analysis was prospectively designed, but not registered. FINDINGS: Seven trials were identified by our search; of 1764 patients included in these trials, 871 were allocated to endovascular thrombectomy and 893 were assigned standard care. After exclusion of 74 patients (72 did not undergo the procedure and two had missing data on anaesthetic strategy), 236 (30%) of 797 patients who had endovascular procedures were treated under GA. At baseline, patients receiving GA were younger and had a shorter delay between stroke onset and randomisation but they had similar pre-treatment clinical severity compared with patients who did not have GA. Endovascular thrombectomy improved functional outcome at 3 months both in patients who had ... |
| نوع الوثيقة: | text |
| اللغة: | unknown |
| العلاقة: | https://scholarlyworks.lvhn.org/radiology-diagnostic-medical-imaging/1059Test; https://pubmed.ncbi.nlm.nih.gov/29263006Test/ |
| الإتاحة: | https://scholarlyworks.lvhn.org/radiology-diagnostic-medical-imaging/1059Test https://pubmed.ncbi.nlm.nih.gov/29263006Test/ |
| رقم الانضمام: | edsbas.A7A561E1 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |