scholarly journals The correlation of intraoperative hypotension and postoperative cognitive impairment: a meta-analysis of randomized controlled trials

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiaojin Feng ◽  
Jialing Hu ◽  
Fuzhou Hua ◽  
Jing Zhang ◽  
Lieliang Zhang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Intraoperative Hypotension ◽  
Postoperative Cognitive Impairment

scholarly journals The correlation of intraoperative hypotension and postoperative cognitive impairment: a meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Xiaojin Feng ◽  
Jialing Hu ◽  
Fuzhou Hua ◽  
Jing Zhang ◽  
Lieliang Zhang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Randomized Controlled Trials ◽  
Postoperative Delirium ◽  
Meta Analysis ◽  
Postoperative Cognitive Dysfunction ◽  
Target Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Intraoperative Hypotension ◽  
Postoperative Cognitive Impairment

Abstract Background: There is no consensus on whether intraoperative hypotension is associated with postoperative cognitive impairment. Hence, we performed a meta-analysis to evaluate the correlation of intraoperative hypotension and the incidence of postoperative delirium (POD) or postoperative cognitive dysfunction (POCD).Methods: We searched PubMed, Embase, and Cochrane Library databases to find randomized controlled trials (RCTs) in which reported the relationship between intraoperative hypotension and POD or POCD. The retrieval time is up to January 2020, without language restrictions. Quality assessment of the eligible studies was conducted by two researchers independently with the Cochrane evaluation system.Results: We analyzed five eligible RCTs. Based on the relative mean arterial pressure (MAP), participants were divided into low-target and high-target groups. For the incidence of POD, there were two studies with 99 participants in the low-target group and 94 participants in the high-target pressure group. For the incidence of POCD, there were four studies involved 360 participants in the low-target group and 341 participants in the high-target group, with a study assessed both POD and POCD. No significant difference between the low-target and the high-target group was observed in the incidence of POD (RR = 3.30, 95% CI 0.80 to 13.54, P = 0.10), or POCD (RR = 1.26, 95% CI 0.76 to 2.08, P = 0.37). Furthermore, it also demonstrates that intraoperative hypotension prolonged the length of ICU stay, but did not increased the mortality, the length of hospital stay, and mechanical ventilation (MV) time.Conclusions: There is no significant correlation between intraoperative hypotension and the incidence of POD or POCD. Keywords: Intraoperative hypotension, Postoperative delirium, Postoperative cognitive dysfunction, Meta-analysis

scholarly journals The correlation of intraoperative hypotension and postoperative cognitive impairment: a meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Xiaojin Feng ◽  
Jialing Hu ◽  
Fuzhou Hua ◽  
Jing Zhang ◽  
Lieliang Zhang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Intraoperative Hypotension ◽  
Significant Difference ◽  
Postoperative Cognitive Impairment

Abstract Background There is no consensus on whether intraoperative hypotension is associated with postoperative cognitive impairment. Hence, we performed a meta-analysis to evaluate the correlation of intraoperative hypotension and the incidence of postoperative delirium (POD) or postoperative cognitive dysfunction (POCD).Methods We searched PubMed, Embase, and Cochrane library databases to find randomized controlled trials (RCTs) in which reported the relationship of intraoperative hypotension and POD or POCD. The retrieval time is up to January 2020, without language restrictions. Quality assessment of the eligible studies was conducted by two researchers independently using the Cochrane evaluation system.Results Five RCTs were included. For the incidence of POD, there are two studies with 99 participants in the low-blood pressure (LP) group and 94 participants in the high-blood pressure (HP) group. For the incidence of POCD, there are four studies with 360 participants in the LP group and 341 participants in the HP group, with a study contains both POD and POCD. No significant difference between the LP and the HP group was observed in the incidence of POD (RR = 3.30, 95% CI 0.80 to 13.54, P = 0.10), or POCD (RR = 1.26, 95% CI 0.76 to 2.08, P = 0.37). Furthermore, it also demonstrated that intraoperative hypotension prolonged the length of ICU stay, but did not increased the mortality, the length of hospital stay, and mechanical ventilation (MV) time.Conclusions There is no significant correlation between intraoperative hypotension and the incidence of POD or POCD.

scholarly journals Acupuncture for Improving Cognitive Impairment After Stroke: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 11 ◽  
Author(s):  
Liang Zhou ◽  
Yao Wang ◽  
Jun Qiao ◽  
Qing Mei Wang ◽  
Xun Luo
Keyword(s):  
Cognitive Impairment ◽  
Randomized Controlled Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Sham Acupuncture ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Post Stroke ◽  
Randomized Controlled ◽  
Therapeutic Benefits

Objective: This meta-analysis evaluated the efficacy of acupuncture in improving cognitive impairment of post-stroke patients.Design: Randomized controlled trials (RCTs) investigating the effects of acupuncture compared with no treatment or sham acupuncture on post-stroke cognitive impairment (PSCI) before December 2019 were identified from databases (PubMed, EMBASE, Ovid library, Cochrane Library, Chinese National Knowledge Infrastructure, VIP Chinese Periodical Database, Wanfang Database, and SinoMed). The literature searching and data extracting were independently performed by two investigators. Study quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analyses were performed for the eligible RCTs with Revman 5.3 software.Results: Thirty-seven RCTs (2,869 patients) were included in this meta-analysis. Merged Random-effects estimates of the gain of MMSE (Mini-Mental State Examination) or MoCA (Montreal Cognitive Assessment) were calculated for the comparison of acupuncture with no acupuncture or sham acupuncture. Following 2–8 weeks of intervention with acupuncture, pooled results demonstrated significant effects of acupuncture in improving PSCI assessed by MMSE (MD [95% CI] = 2.88 [2.09, 3.66], p < 0.00001) or MoCA (MD [95% CI] = 2.66 [1.95, 3.37], p < 0.00001).Conclusion: The results suggest that acupuncture was effective in improving PSCI and supported the needs of more rigorous design with large-scale randomized clinical trials to determine its therapeutic benefits.

scholarly journals Cognitive rehabilitation interventions after stroke: protocol for a systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Qing Zhao ◽  
Xue Wang ◽  
Tao Wang ◽  
Adam A. Dmytriw ◽  
Xiao Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Cognitive Impairment ◽  
Randomized Controlled Trials ◽  
Cognitive Rehabilitation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Post Stroke ◽  
Randomized Controlled

Abstract Background Stroke is the second leading cause of death worldwide, and 53.4% of stroke survivors suffer from post-stroke cognitive impairment. Post-stroke cognitive impairment can increase hospitalization rate and cost of care and decrease the quality of life of stroke patients. To date, multiple cognitive rehabilitation interventions have been tested in stroke populations with post-stroke cognitive impairment. However, the most efficacious intervention has not been established. This systematic review aims to compare the efficacy of cognitive rehabilitation interventions for patients with post-stroke cognitive impairment. Methods We will search MEDLINE, EMBASE, CENTRAL, PsycINFO, CINAHL, PubMed, and clinical trial registries to identify eligible randomized clinical trials with no restrictions in the date of publication and language. Studies conducted with patients aged 18 or over, with the presence of cognitive impairment after being diagnosed with stroke will be included. Studies will be restricted to randomized controlled trials comparing a cognitive rehabilitation intervention with another intervention. The primary outcome is any clinical changes in the general or specific cognitive domain (e.g., executive function, attention, memory, or perception). The secondary outcomes that will be collected include adverse effects (e.g., stroke, disability, or mortality) and quality of life. Two independent reviewers will assess articles to identify trials eligible for inclusion. Data extraction and risk of bias assessment of the included studies will also be done independently. Any discrepancies will be solved by discussion, or a third reviewer will be consulted if necessary. A meta-analysis will be carried out if appropriate. Discussion This systematic review for patients with post-stroke cognitive impairment will assess the efficacy of cognitive rehabilitation interventions. And our results will help clinical decision-making and support the development of clinical practice guidelines. Trial registration Systematic review registration: PROSPERO CRD42020173988

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