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Titolo:
Systematic review of prediction of poor outcome in anoxic-ischaemic coma with biochemical markers of brain damage
Autore:
Zandbergen, EGJ; de Haan, RJ; Hijdra, A;
Indirizzi:
Univ Amsterdam, Acad Med Ctr, Dept Neurol & Clin Neurophysiol, NL-1100 DD Amsterdam, Netherlands Univ Amsterdam Amsterdam Netherlands NL-1100 DD D Amsterdam, Netherlands Univ Amsterdam, Acad Med Ctr, Dept Clin Epidemiol & Biostat, NL-1100 DD Amsterdam, Netherlands Univ Amsterdam Amsterdam Netherlands NL-1100 DD D Amsterdam, Netherlands
Titolo Testata:
INTENSIVE CARE MEDICINE
fascicolo: 10, volume: 27, anno: 2001,
pagine: 1661 - 1667
SICI:
0342-4642(200110)27:10<1661:SROPOP>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEURON-SPECIFIC ENOLASE; FLUID CREATINE-KINASE; GLOBAL CEREBRAL-ISCHEMIA; HOSPITAL CARDIAC-ARREST; CEREBROSPINAL-FLUID; BB ACTIVITY; SERUM; INJURY; CSF; RESUSCITATION;
Keywords:
cerebral anoxia; coma; creatine kinase; nerve tissue protein S-100; phosphopyruvate hydratase; predictive value of tests;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Hijdra, A Univ Amsterdam, Acad Med Ctr, Dept Neurol & Clin Neurophysiol, POB 22660, NL-1100 DD Amsterdam, Netherlands Univ Amsterdam POB 22660 Amsterdam Netherlands NL-1100 DD lands
Citazione:
E.G.J. Zandbergen et al., "Systematic review of prediction of poor outcome in anoxic-ischaemic coma with biochemical markers of brain damage", INTEN CAR M, 27(10), 2001, pp. 1661-1667

Abstract

Objective: To investigate whether accurate prognostic rules can be derivedfrom the combined results of studies concerning prediction of poor prognosis in anoxic-ischaemic coma with biochemical markers of brain damage in cerebrospinal fluid (CSF) or serum. Design: A meta-analysis of prognostic studies in anoxic-ischaemic coma, selected from Medline and EMBASE databases, according to predefined criteria. Subjects: Twenty-eight studies, with a total of 802 unselected, consecutive patients, in which tests, sampling time and outcome measures were described unequivocally and results were described using clear cut-off values or raw data. Main outcome measures: Poor outcome, defined as death or vegetative state,versus good outcome, defined as any other outcome state. Analyses: The overall prognostic accuracy of these variables was expressedas the 95 % CIs of the pooled false-positive test rate and the pooled positive-likelihood ratios. Results: Only markers in CSF (creatine kinase isoenzyme (CKBB) > 204 U/l, neuron specific enolase (NSE) > 33 ng/ml, lactate dehydrogenase (LDH) > 82 U/l and glutamate oxaloacetate (GOT) > 62 U/l) reached a 0 % false-positiverate. However, due to small sample sizes, the confidence limits were wide. The accuracy of prediction of poor outcome seemed acceptably high for CSF-CKBB (pooled false-positive rate 0 % [95 % CI 0-2.3 % ]; pooled positive-likelihood ratio 33.2 [95 % CI 4.8-230.2]), but this result was based on two retrospective studies without blinding of the treating physicians for the test result. Conclusions: Because of small numbers of patients studied and methodological limitations the combined results are not sufficiently accurate to provide a solid basis for nontreatment decisions.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/04/20 alle ore 11:38:52