Prognostic value of net water uptake in acute ischemic stroke: a protocol for a systematic review and meta-analysis
Review question / Objective: The purpose of this protocol is to present a transparent and clear methodology for performing a systematic review and meta-analysis of the available literature aimed to answer the following question: among patients with acute ischemic stroke due to large vessel occlusion, is net water uptake (NWU), as measured in CT images, associated with (i) cerebrovascular complications, including malignant cerebral edema, secondary intracerebral hemorrhage, and (ii) post-stroke functional outcome as measured by the modified Rankin Scale. Condition being studied: Currently, the association between net water uptake with cerebrovascular complications or post-stroke functional outcomes is not well defined. Broocks found that NWU based on CT was an important marker for malignant edema in LVO patients and independently associated with clinical prognosis. Additionally, Nawabi indicated that a higher degree of NWU was a predictor of intracranial hemorrhage in patients with acute ischemic stroke treated with mechanical thrombectomy. Thus, a higher NWU might contribute to the development of stroke complications and poorer outcomes. However, no systematic review and meta-analysis to quantitatively summarize this evidence and help establish the predictive value of NWU in patients with acute ischemic stroke.