Evidence map›Paper›PMID 31077134›Full record

SynthesisBMC anesthesiology2019

Outcomes of general anesthesia versus conscious sedation for Stroke undergoing endovascular treatment: a meta-analysis.

Teng-Fei Wan, Rui Xu, Zi-Ai Zhao, Yan Lv, Hui-Sheng Chen, Liang Liu

Open access · goldAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC anesthesiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Review
  5. Article
  6. An update on hyper-acute management of ischaemic stroke.Clinical medicine (London, England) · 2021
    Review
  7. Article
  8. Article
  9. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Teng-Fei WanDepartment of First Cadre Ward, the General Hospital of Northern Theater Command, No. 83 Wenhua Street, Shenyang, 110016, Liaoning, China.
Rui XuDepartment of Neurology, Xinqiao Hospital, the Army Medical University, NO. 183 Xinqiao mian street, Chongqing, 400037, China.
Zi-Ai ZhaoDepartment of Neurology, the General Hospital of Northern Theater Command , No. 83 Wenhua Street, Shenyang, 110016, Liaoning, China.
Yan LvDepartment of Neurology, the General Hospital of Northern Theater Command , No. 83 Wenhua Street, Shenyang, 110016, Liaoning, China.
Hui-Sheng ChenDepartment of Neurology, the General Hospital of Northern Theater Command , No. 83 Wenhua Street, Shenyang, 110016, Liaoning, China. chszh@aliyun.com.
Liang LiuDepartment of Neurology, the General Hospital of Northern Theater Command , No. 83 Wenhua Street, Shenyang, 110016, Liaoning, China. 18580763671@163.com.ORCID 0000-0002-6825-0474
General Hospital of Shenyang Military Region · CNArmy Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe impact of anesthesia strategy on the outcomes of acute ischemic stroke (AIS) patients undergoing endovascular treatment is currently controversy. Thus, we performed this meta-analysis to compare the differences of clinical and angiographic outcomes between general anesthesia (GA) and conscious sedation (CS).

methodsA literature search in PubMed, Embase, and Web of Knowledge databases through February 2019 was conducted for related records on GA and CS of AIS undergoing endovascular treatment. The results of the studies were pooled and meta-analyzed with fixed- or random-effect model based on heterogeneity test in total and subgroup analyses.

resultsTwenty-three studies including 6703 patients were analyzed in this meta-analysis. We found that patients in the GA group have lower odds of favorable functional outcome (mRS scores ≤2) compared with the CS group (odds ratio [OR] = 0.62, 95% confidence interval [CI]: 0.49-0.77), and higher risk of mortality (OR = 1.68, 95% CI: 1.49-1.90), pneumonia (OR = 1.78, 95% CI: 1.40-2.26), symptomatic intracranial hemorrhage (OR = 1.64, 95% CI: 1.13-2.37). However, no significant differences were seen between the groups in the rate of recanalization (OR = 1.07, 95% CI: 0.89-1.28), vessel dissection or perforation (OR = 1.00, 95% CI: 0.98-1.03) and asymptomatic intracranial hemorrhage (OR = 1.19, 95% CI: 0.96-1.47). While in the RCT subgroup analysis, we found patients in the GA group does not show lower rate of favorable functional outcome compared with the CS group (OR = 1.84, 95% CI: 1.17-2.89). And there was no significant difference in the rate of mortality between GA and CS groups during RCT subgroup analysis (OR = 0.74, 95% CI: 0.43-1.27).

conclusionsAIS patients performed endovascular treatment under GA compared with CS was associated with worse functional outcome and increased rate of mortality, but differences in worsened outcomes do not exist when one looks into the GA vs. CS RCTs. Moreover, these findings are mainly based on the retrospective studies and additional multi-center randomized controlled trials to definitively address these issues is warranted.

Indexed as

Anesthesia, GeneralBrain IschemiaEndovascular ProceduresHumansProcedural SedationRandomized Controlled Trials as TopicRetrospective StudiesStrokeTreatment OutcomeAnesthesiaEndovascular treatmentIschemic strokeMeta-analysis

Identifiers

PMID31077134
PMCPMC6511209
OpenAlexW2947652194

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.