So you found a problem but did nothing to solve it. Useless. Nothing on any followup needed or change to the stroke strategy to actually solve this problem. If all I ever did was describe programming problems and not solve them I'd be fired in no time. The same should apply here, going up to the mentors and senior researchers also.
Prophylactic Antiseizure Drugs for Spontaneous Intracerebral Hemorrhage: An Updated Systematic Review and Meta-analysis
Abstract
Background:
There is concern that recommendations on prophylactic antiseizure drugs
(PASDs) for patients with spontaneous intracerebral hemorrhage (sICH)
are biased by studies using older drugs and no electrographic
monitoring.
Aims:
We performed a systematic
review and meta-analysis to determine whether PASDs in patients with
sICH reduced seizure occurrence and improved functional outcomes. We
included analyses of newer trials, newer antiseizure drugs, and
effectiveness in patients with consistent electrographic monitoring.
Methods:
Medline, Embase, and Cochrane were searched from inception until August
12th, 2022, to identify studies with patients with sICH treated with
PASDs, regardless of study design. The studied outcomes were functional
status and occurrence of seizures.
Results:
14 studies were included, including 6742 patients. Risk of bias was low
overall. There was no effect of PASD on seizure occurrence overall (OR
0.73, 95% CI 0.47-1.15) but they were associated with reduced occurrence
in studies with electrographic monitoring (OR 0.36, 95% CI 0.18-0.70).
There was no effect of PASDs on functional outcomes (OR 1.15; 95% CI
0.91-1.47) or mortality (OR 0.85, 95% CI 0.65-1.11).
Conclusions:
Prophylactic antiseizure medications after spontaneous intracerebral
hemorrhage reduce seizures in studies with EEG monitoring in high-risk
patients. However, this benefit did not reflect in improvement of
functional outcomes, even in studies with newer, less toxic, antiseizure
drugs.
No comments:
Post a Comment