You Q, Yang Y, Hu H. White Matter Hyperintensities and Functional Outcomes in Patients With Cerebral Hemorrhage: A Systematic Review and Meta-Analysis.
Front Neurol 2022;
13:820012. [PMID:
35386407 PMCID:
PMC8978301 DOI:
10.3389/fneur.2022.820012]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives
There are controversies about white matter hyperintensities (WMH) and the prognosis of spontaneous intracerebral hemorrhage. Our objective is to investigate the relationship between WMH and functional outcomes after intracerebral hemorrhage (ICH).
Methods
We systematically searched PubMed, EMBASE, and Cochrane Library databases from inception through August 10, 2021 without any restriction of countries. Articles investigating the relationship of WMH and functional outcomes as well as mortality of patients with spontaneous ICH were included. We extracted relevant data and evaluated the study quality with the Newcastle-Ottawa Scale. We pooled odds ratio (OR) for the presence and different severities of WMH with random effects models using STATA.
Results
A total of 10,584 patients with ICH in 18 studies were included in the analysis. Moderate/severe WMH were related to poor functional outcome [OR, 1.805, 95% confidence interval (CI), 1.320–2.469] and all-cause mortality (OR, 3.27, 95% CI, 2.07–5.18) after ICH. Besides, the increasing severity of WMH was also related to poor functional outcome (OR, 1.34, 95% CI, 1.17–1.53) and all-cause mortality (OR, 1.62, 95% CI, 1.39–1.90). The pooled data did not find the relationship between the presence of WMH and poor functional outcome (OR, 2.54, 95% CI, 0.91–7.05) after ICH. The results remained stable after adjusting for age, hematoma volume, stroke, and intraventricular hemorrhage.
Conclusion
We found moderate and severe WMH were related to poor functional outcomes and all-cause mortality after ICH. High-quality prospective studies are still needed.
Systematic Review Registration
https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021278409.
Collapse