The Efficacy of Adjuvant Corticosteroids in Surgical Management of Chronic Subdural Hematoma: A Systematic Review and Meta-Analysis

Objective: This systematic review aimed to assess the efficacy of adjuvant corticosteroids in managing patients with chronic subdural hematoma (CSDH) undergoing surgical intervention.Methods: We searched for eligible studies electronically on the databases of PubMed, Embase, and Google Scholar. The last date of the search was 15th Jun 2021. Outcomes were pooled to calculate risk ratios (RR) with 95% confidence intervals (CI).Results: Eleven studies were included. Four of them were randomized controlled trials (RCTs). Six studies reported data on good neurological outcomes but with variable definitions. Combining all studies, we noted no statistically significant difference in good neurological outcome with the use of adjuvant corticosteroids (RR: 0.91 95% CI: 0.74, 1.12 I2 = 92% p = 0.39). Similar results were obtained on subgroup analysis based on definition and study type. However, the use of adjuvant corticosteroids was associated with a significantly reduced risk of recurrence (RR: 0.51 95% CI: 0.40, 0.64 I2 = 0% p < 0.0001). The meta-analysis also demonstrated no statistically significant difference in mortality rates with the use of adjuvant corticosteroids (RR: 1.01 95% CI: 0.47, 2.21 I2 = 76% p = 0.97). The results did not differ between RCTs and non-RCTs. Limited studies reported data on complications, and pooled analysis indicated no significant increase in infectious, gastrointestinal, and neurological complications with the use of adjuvant corticosteroids.Conclusion: The use of corticosteroids with surgery for CSDH might be associated with a reduction in recurrence rate. However, corticosteroids do not improve functional outcomes or mortality rates. Future studies should assess the impact of different corticosteroid regimens on patient outcomes, and should use standardized reporting of neurological outcomes with uniform follow-up duration.

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Herbal medicine treatment for patients with chronic subdural hematoma: A systematic review and meta-analysis

Complementary Therapies in Clinical Practice ◽

10.1016/j.ctcp.2021.101307 ◽

2021 ◽

Vol 43 ◽

pp. 101307

Author(s):

Seungwon Kwon ◽

Chul Jin ◽

Minho Chung ◽

JiEun Lee ◽

Seung-Yeon Cho ◽

...

Keyword(s):

Systematic Review ◽

Herbal Medicine ◽

Subdural Hematoma ◽

Meta Analysis ◽

Chronic Subdural Hematoma

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Letter to the Editor Regarding: “Middle Meningeal Artery Embolization for Chronic Subdural Hematoma: Meta-Analysis and Systematic Review”

World Neurosurgery ◽

10.1016/j.wneu.2018.12.138 ◽

2019 ◽

Vol 124 ◽

pp. 480-481

Author(s):

Daniele Starnoni ◽

Lorenzo Giammattei ◽

Mahmoud Messerer ◽

Roy Thomas Daniel

Keyword(s):

Systematic Review ◽

Subdural Hematoma ◽

Meta Analysis ◽

Chronic Subdural Hematoma ◽

Middle Meningeal Artery ◽

Artery Embolization ◽

Letter To The Editor ◽

Meningeal Artery

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Efficacy and Safety of Glucocorticoids versus Placebo as an Adjuvant Treatment to Surgery in Chronic Subdural Hematoma: A Systematic Review and Meta-analysis of Randomized Controlled Clinical Trials

World Neurosurgery ◽

10.1016/j.wneu.2021.12.013 ◽

2021 ◽

Author(s):

Yangyang Zhao ◽

Qiuxiang Xiao ◽

Wenxiang Tang ◽

Renyong Wang ◽

Muyun Luo

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Adjuvant Treatment ◽

Subdural Hematoma ◽

Meta Analysis ◽

Chronic Subdural Hematoma ◽

Efficacy And Safety ◽

Controlled Clinical Trials ◽

Randomized Controlled Clinical Trials ◽

Randomized Controlled

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Twist drill craniostomy vs burr hole drainage of chronic subdural hematoma: a systematic review and meta-analysis

Acta Neurochirurgica ◽

10.1007/s00701-021-05019-3 ◽

2021 ◽

Author(s):

Karan J. Yagnik ◽

Anshit Goyal ◽

Jamie J. Van Gompel

Keyword(s):

Systematic Review ◽

Subdural Hematoma ◽

Meta Analysis ◽

Chronic Subdural Hematoma ◽

Burr Hole ◽

Twist Drill

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The Seroprevalence of SARS-CoV-2 in Europe: A Systematic Review

10.1101/2021.04.12.439425 ◽

2021 ◽

Author(s):

Natasha Marcella Vaselli ◽

Daniel Hungerford ◽

Ben Shenton ◽

Arwa Khashkhusha ◽

Nigel A. Cunliffe ◽

...

Keyword(s):

Public Health ◽

Systematic Review ◽

Meta Analysis ◽

Grey Literature ◽

Age Groups ◽

Significant Heterogeneity ◽

Community Studies ◽

Past Infection ◽

Significant Difference ◽

The Impact

AbstractBackgroundA year following the onset of the COVID-19 pandemic, new infections and deaths continue to increase in Europe. Serological studies, through providing evidence of past infection, can aid understanding of the population dynamics of SARS-CoV-2 infection.ObjectivesThis systematic review of SARS-CoV-2 seroprevalence studies in Europe was undertaken to inform public health strategies including vaccination, that aim to accelerate population immunity.MethodsWe searched the databases Web of Science, MEDLINE, EMBASE, SCOPUS, Cochrane Database of Systematic Reviews and grey literature sources for studies reporting seroprevalence of SARS-CoV-2 antibodies in Europe published between 01/12/2019 - 30/09/20. We provide a narrative synthesis of included studies. Studies were categorized into subgroups including healthcare workers (HCWs), community, outbreaks, pregnancy and children/school. Due to heterogeneity in other subgroups, we only performed a random effects meta-analysis of the seroprevalence amongst HCWs stratified by their country.Results109 studies were included spanning 17 European countries, that estimated the seroprevalence of SAR-CoV2 from samples obtained between November 2019 – August 2020. A total of 53/109 studies included HCWs with a reported seroprevalence among HCWs ranging from 0.7% to 45.3%, which did not differ significantly by country. In community studies significant heterogeneity was reported in the seroprevalence among different age groups and the majority of studies reported there was no significant difference by gender.ConclusionThis review demonstrates a wide heterogeneity in reported seroprevalence of SARS-CoV-2 antibodies between populations. Continued evaluation of seroprevalence is required to understand the impact of public health measures and inform interventions including vaccination programmes.

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Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis

European Journal of Epidemiology ◽

10.1007/s10654-020-00678-5 ◽

2020 ◽

Vol 35 (8) ◽

pp. 763-773 ◽

Cited By ~ 6

Author(s):

Petek Eylul Taneri ◽

Sergio Alejandro Gómez-Ochoa ◽

Erand Llanaj ◽

Peter Francis Raguindin ◽

Lyda Z. Rojas ◽

...

Keyword(s):

Systematic Review ◽

Iron Metabolism ◽

Binding Capacity ◽

Ferritin Level ◽

Meta Analysis ◽

Older Age ◽

Bibliographic Databases ◽

Distribution Width ◽

Significant Difference ◽

The Impact

Abstract Iron metabolism and anemia may play an important role in multiple organ dysfunction syndrome in Coronavirus disease 2019 (COVID-19). We conducted a systematic review and meta-analysis to evaluate biomarkers of anemia and iron metabolism (hemoglobin, ferritin, transferrin, soluble transferrin receptor, hepcidin, haptoglobin, unsaturated iron-binding capacity, erythropoietin, free erythrocyte protoporphyrine, and erythrocyte indices) in patients diagnosed with COVID-19, and explored their prognostic value. Six bibliographic databases were searched up to August 3rd 2020. We included 189 unique studies, with data from 57,563 COVID-19 patients. Pooled mean hemoglobin and ferritin levels in COVID-19 patients across all ages were 129.7 g/L (95% Confidence Interval (CI), 128.51; 130.88) and 777.33 ng/mL (95% CI, 701.33; 852.77), respectively. Hemoglobin levels were lower with older age, higher percentage of subjects with diabetes, hypertension and overall comorbidities, and admitted to intensive care. Ferritin level increased with older age, increasing proportion of hypertensive study participants, and increasing proportion of mortality. Compared to moderate cases, severe COVID-19 cases had lower hemoglobin [weighted mean difference (WMD), − 4.08 g/L (95% CI − 5.12; − 3.05)] and red blood cell count [WMD, − 0.16 × 1012 /L (95% CI − 0.31; − 0.014)], and higher ferritin [WMD, − 473.25 ng/mL (95% CI 382.52; 563.98)] and red cell distribution width [WMD, 1.82% (95% CI 0.10; 3.55)]. A significant difference in mean ferritin levels of 606.37 ng/mL (95% CI 461.86; 750.88) was found between survivors and non-survivors, but not in hemoglobin levels. Future studies should explore the impact of iron metabolism and anemia in the pathophysiology, prognosis, and treatment of COVID-19.

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mHealth interventions in the management of heart failure, ischaemic heart disease and hypertension: a systematic review and meta-analysis of randomised controlled trials

European Heart Journal ◽

10.1093/ehjci/ehaa946.3507 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

P Indraratna ◽

D Tardo ◽

J Yu ◽

K Delbaere ◽

M Brodie ◽

...

Keyword(s):

Heart Failure ◽

Systematic Review ◽

Heart Disease ◽

Ischaemic Heart Disease ◽

Meta Analysis ◽

Funding Source ◽

Smartphone Applications ◽

Coronary Syndrome ◽

Significant Difference ◽

The Impact

Abstract Introduction Cardiovascular disease (CVD) remains the leading cause of death in the world. Mobile phones have become ubiquitous in most developed societies. Smartphone applications, telemonitoring and clinician-driven short message service (SMS) allow for novel methods in managing chronic cardiovascular conditions such as ischaemic heart disease, heart failure and hypertension. Purpose To evaluate the impact of mobile phone-based interventions (MPIs) on mortality, hospitalisations and blood pressure and body mass index (BMI) in patients diagnosed with either acute coronary syndrome, heart failure or hypertension. Methods A systematic review was conducted using seven electronic databases, identifying all randomised control trials (RCTs) featuring an MPI in the management of these conditions. Meta-analysis was performed by using standard analytical techniques. The odds ratio (OR) was used as a summary statistic. Results Twenty-six RCTs including 6,713 patients were identified. Of these 26 studies, 13 examined text messaging intereventions, 10 studied telemonitoring interventions and three described smartphone applications with other functions. Twelve studies were included for meta-analysis. In patients with heart failure (n=1683), MPIs were associated with a significantly lower rate of all-cause hospital admissions at six months (31% vs. 36%, OR 0.77, 95% CI 0.62–0.97, p=0.03, I2 = 0). A significant difference was also demonstrated for heart-failure admissions (14.0% vs. 18.5%, OR 0.69, 95% CI 0.48 to 0.98, p=0.04, I2 = 26%). There was no difference in mortality (10.4% vs. 11.6% p=0.45). In patients with hypertension, the difference in systolic BP was 4.3mmHg less in the intervention group (95% CI: −7.8 to −0.78 mmHg, p=0.02). Four studies examined medication compliance as an endpoint in patients with ischaemic heart disease, and all four demonstrated a significant difference favouring the MPI group (see table 1). However, due to variable quantification of compliance, meta-analysis was not possible. There was no significant difference in the change in BMI from four studies after six or more months (mean difference −0.46, 95% CI: −1.44 to 0.52, P=0.36). Conclusions The available data suggests MPIs may have a role as valuable adjuncts in the management of chronic CVD. Figure 1 Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Health and Medical Research Council (NHMRC)

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Middle meningeal artery embolization for chronic subdural hematoma: a systematic review and meta-analysis

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2021-017352 ◽

2021 ◽

pp. neurintsurg-2021-017352

Author(s):

Natasha Ironside ◽

Candice Nguyen ◽

Quan Do ◽

Beatrice Ugiliweneza ◽

Ching-Jen Chen ◽

...

Keyword(s):

Systematic Review ◽

Minimally Invasive ◽

Subdural Hematoma ◽

Meta Analysis ◽

Chronic Subdural Hematoma ◽

Middle Meningeal Artery ◽

Definitive Treatment ◽

Complication Rates ◽

Conventional Management ◽

Meningeal Artery

Middle meningeal artery (MMA) embolization has been proposed as a minimally invasive treatment for chronic subdural hematoma (cSDH). The aim of this systematic review and meta-analysis is to compare outcomes after MMA embolization versus conventional management for cSDH. We performed a systematic review of PubMed, Embase, Oxford Journal, Cochrane, and Google Scholar databases from April 1987 to October 2020 in accordance with PRISMA guidelines. Studies reporting outcomes after MMA embolization for ≥3 patients with cSDH were included. A meta-analysis comparing MMA embolization with conventional management was performed. The analysis comprised 20 studies with 1416 patients, including 718 and 698 patients in the MMA embolization and conventional management cohorts, respectively. The pooled recurrence, surgical rescue, and in-hospital complication rates in the MMA embolization cohort were 4.8% (95% CI 3.2% to 6.5%), 4.4% (2.8% to 5.9%), and 1.7% (0.8% to 2.6%), respectively. The pooled recurrence, surgical rescue, and in-hospital complication rates in the conventional management cohort were 21.5% (0.6% to 42.4%), 16.4% (5.9% to 27.0%), and 4.9% (2.8% to 7.1%), respectively. Compared with conservative management, MMA embolization was associated with lower rates of cSDH recurrence (OR=0.15 (95% CI 0.03 to 0.75), p=0.02) and surgical rescue (OR=0.21 (0.07 to 0.58), p=0.003). In-hospital complication rates were comparable between the two cohorts (OR=0.78 (0.34 to 1.76), p=0.55). MMA embolization is a promising minimally invasive therapy that may reduce the need for surgical intervention in appropriately selected patients with cSDH. Additional prospective studies are warranted to determine the long-term durability of MMA embolization, refine eligibility criteria, and establish this endovascular approach as a viable definitive treatment for cSDH.

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