Abstract：
BACKGROUND: Brain atrophy (BA) may have a role in acute ischemic stroke (AIS) in mediating outcomes after reperfusion therapy. The extent of this association is not well understood.
OBJECTIVE: : To examine the impact of pre-existing BA on functional outcome, survival, symptomatic intracerebral hemorrhage (sICH), and early neurological change in patients with AIS treated with intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT).
METHODS: PubMed, EMBASE, and the Cochrane library were searched for studies on BA in AIS receiving reperfusion therapy. Studies were included if: (i) patients were aged ≥18 years; (ii) patients had been diagnosed with AIS; (iii) patients received IVT and/or EVT; (iv) studies reported on BA; (v) studies reported on post-reperfusion outcomes; and (vi) studies had a sample size of >25 patients.
RESULTS: A total of 4444 patients from eight studies were included. Four out of seven studies reporting on 90-day functional outcome found pre-existing BA to be significantly associated with poor functional outcome. Moreover, two out of four studies found BA to be a significant predictor of 90-day mortality. None of the included studies reported a significant association of BA with sICH or early neurological deterioration.
CONCLUSIONS: This systematic review indicates a potential prognostic role of BA in AIS. Quantitative analysis of association of BA with outcomes in AIS is not possible given the heterogeneity in BA assessment and reporting across studies. Future studies using standardized BA assessment are warranted to clarify its association with clinical and safety outcomes in AIS.
OBJECTIVE: : To examine the impact of pre-existing BA on functional outcome, survival, symptomatic intracerebral hemorrhage (sICH), and early neurological change in patients with AIS treated with intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT).
METHODS: PubMed, EMBASE, and the Cochrane library were searched for studies on BA in AIS receiving reperfusion therapy. Studies were included if: (i) patients were aged ≥18 years; (ii) patients had been diagnosed with AIS; (iii) patients received IVT and/or EVT; (iv) studies reported on BA; (v) studies reported on post-reperfusion outcomes; and (vi) studies had a sample size of >25 patients.
RESULTS: A total of 4444 patients from eight studies were included. Four out of seven studies reporting on 90-day functional outcome found pre-existing BA to be significantly associated with poor functional outcome. Moreover, two out of four studies found BA to be a significant predictor of 90-day mortality. None of the included studies reported a significant association of BA with sICH or early neurological deterioration.
CONCLUSIONS: This systematic review indicates a potential prognostic role of BA in AIS. Quantitative analysis of association of BA with outcomes in AIS is not possible given the heterogeneity in BA assessment and reporting across studies. Future studies using standardized BA assessment are warranted to clarify its association with clinical and safety outcomes in AIS.
摘要：
背景：脑萎缩（BA）可能在急性缺血性卒中（AIS）中具有介导再灌注治疗后预后的作用。这种联系的程度还没有得到很好的理解。
目的：：研究预先存在的BA对功能结局的影响，生存,症状性脑出血（sICH），静脉溶栓（IVT）和/或血管内血栓切除术（EVT）治疗的AIS患者的早期神经系统变化。
方法：PubMed，EMBASE,并在Cochrane文库中进行了对接受再灌注治疗的AIS中BA的研究。如果(i)患者年龄≥18岁;(ii)患者已被诊断为AIS;(iii)患者接受IVT和/或EVT;(iv)关于BA的研究;(v)关于再灌注后结果的研究;和(vi)研究的样本量>25名患者,则纳入研究。
结果：共纳入了来自8项研究的4444名患者。在报告90天功能结局的七项研究中，有四项发现预先存在的BA与不良的功能结局显着相关。此外，4项研究中有2项发现BA是90天死亡率的重要预测因子.没有一项纳入的研究报告BA与sICH或早期神经系统恶化有显著关联。
结论：本系统综述表明BA在AIS中的潜在预后作用。考虑到研究中BA评估和报告的异质性，无法定量分析BA与AIS结果的关联。使用标准化BA评估的未来研究有必要阐明其与AIS临床和安全性结果的关联。
目的：：研究预先存在的BA对功能结局的影响，生存,症状性脑出血（sICH），静脉溶栓（IVT）和/或血管内血栓切除术（EVT）治疗的AIS患者的早期神经系统变化。
方法：PubMed，EMBASE,并在Cochrane文库中进行了对接受再灌注治疗的AIS中BA的研究。如果(i)患者年龄≥18岁;(ii)患者已被诊断为AIS;(iii)患者接受IVT和/或EVT;(iv)关于BA的研究;(v)关于再灌注后结果的研究;和(vi)研究的样本量>25名患者,则纳入研究。
结果：共纳入了来自8项研究的4444名患者。在报告90天功能结局的七项研究中，有四项发现预先存在的BA与不良的功能结局显着相关。此外，4项研究中有2项发现BA是90天死亡率的重要预测因子.没有一项纳入的研究报告BA与sICH或早期神经系统恶化有显著关联。
结论：本系统综述表明BA在AIS中的潜在预后作用。考虑到研究中BA评估和报告的异质性，无法定量分析BA与AIS结果的关联。使用标准化BA评估的未来研究有必要阐明其与AIS临床和安全性结果的关联。
