Perihematomal Edema and Functional Outcome After Intracerebral Hemorrhage: A Meta-Analysis of Individual Participant Data.

We aimed to determine the direction, strength, and temporality of the association between PHE and functional outcome after ICH onset.

我们旨在确定PHE与ICH发生后功能结果之间的方向、强度和时间性的关联。

Methods

We did a systematic reviewto identify cohort studies or trials that used brain computed tomography (CT) imaging to diagnose ICH, and measured functional outcome.

我们进行了一项系统评价，以确定使用脑部计算机断层扫描（CT）成像诊断自发性脑出血（ICH）的队列研究或试验，并测量了功能结果。

We sought individual participant data if they had a diagnostic CT within 72 hours, a repeat CT within 14 days of the diagnostic scan, and were not treated with surgery or therapy that could affect PHE.

如果他们在诊断CT后的72小时内进行了个体参与者数据的收集，并在诊断扫描后的14天内进行了重复CT扫描，且未接受可能影响PHE的手术或治疗，我们就寻求这些数据。

We did a 2-stage individual participant data meta-analysis.

我们进行了两阶段的个体患者数据荟萃分析。

The primary analysis was the association between the change in absolute PHE volume between the diagnostic CT and repeat CT and the primary outcome of death or dependence (modified Rankin Scale score, 3-6) at 90±14 days after ICH onset.

主要分析是诊断CT和复查CT之间绝对PHE体积变化与ICH发病后90±14天主要结果（死亡或依赖，改良Rankin量表评分3-6）之间的关联。

We quantified the association between change in absolute PHE volume at 2 repeat CT time points (24±12 and 72±12 hours) and outcome, both unadjusted and adjusted for age, sex, ICH volume on the diagnostic CT, and intraventricular extension using multivariable logistic regression.

我们在两个重复CT时间点（24±12小时和72±12小时）上量化了绝对PHE体积变化与结果之间的关联，包括未调整和调整年龄、性别、诊断CT上的ICH体积以及脑室内扩展的情况，使用多变量逻辑回归进行分析。

Results

From 12 969 studies, 38 were eligible, of which 12 studies (with 1 unpublished cohort and the VISTA [Virtual International Stroke Trials Archive]-ICH databank) provided data.

在12 969项研究中，有38项符合资格，其中12项研究（包括1个未发表的队列和VISTA-ICH数据库）提供了数据。

We included 1523 participants, of whom 1347 participants (516 [38%] participants female; median age, 66 [interquartile range, 55-75] years) had repeat CT at 24±12 hours, and 495 (195 [39%] participants female; median age, 66 [interquartile range, 55-74] years) had repeat CT at 72±12 hours. 319 participants contributed to both analyses.

我们纳入了1523名参与者，其中1347名参与者（516名女性，占38%；中位年龄66岁，四分位数间距为55-75岁）在24±12小时进行了CT复查，另外495名参与者（195名女性，占39%；中位年龄66岁，四分位数间距为55-74岁）在72±12小时进行了CT复查。共有319名参与者参与了这两项分析。

Death or dependence was associated with absolute PHE growth both in the first 24±12 hours (unadjusted odds ratio, 1.04 per mL increase [95% CI, 1.01-1.06]; P<0.01; adjusted odds ratio, 1.04 per mL increase [95% CI, 1.01-1.06]; P<0.01) and in the first 72±12 hours (unadjusted odds ratio, 1.03 per mL [95% CI, 1.01-1.04]; P<0.01; adjusted odds ratio, 1.02 [95% CI, 1.01-1.04] per 1 mL increase; P<0.01).

死亡或依赖与绝对的PHE增长在最初的24±12小时（未调整的比值比为每毫升增加1.04 [95%置信区间，1.01-1.06]；P<0.01；调整后的比值比为每毫升增加1.04 [95%置信区间，1.01-1.06]；P<0.01）以及在最初的72±12小时（未调整的比值比为每毫升增加1.03 [95%置信区间，1.01-1.04]；P<0.01；调整后的比值比为每毫升增加1.02 [95%置信区间，1.01-1.04]；P<0.01）都有关联。

Conclusions

PHE growth within 24 and 72 hours of ICH onset is independently associated with death or dependence after ICH.

ICH发作后24小时和72小时内的PHE增长与ICH后的死亡或依赖独立相关。