Evidence map›Paper›PMID 32895713›Full record

SynthesisOperative neurosurgery (Hagerstown, Md.)2021

Deep Brain Electrode Externalization and Risk of Infection: A Systematic Review and Meta-Analysis.

Alon Kashanian, Pratik Rohatgi, Srinivas Chivukula, Sameer A Sheth, Nader Pouratian

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Operative neurosurgery (Hagerstown, Md.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

5 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Article
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

5 authors.

Alon KashanianDepartment of Neurosurgery, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, California.
Pratik RohatgiDepartment of Neurosurgery, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, California.
Srinivas ChivukulaDepartment of Neurosurgery, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, California.
Sameer A ShethDepartment of Neurosurgery, Baylor College of Medicine, Houston, Texas.
Nader PouratianDepartment of Neurosurgery, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, California.

Funding

Deep brain stimulation for depression using directional current steering an individualized network targetingUH3NS103549 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GOODMAN, WAYNE K, POURATIAN, NADER · 2017 to 2025
$8.7M
GENETIC MANIPULATION OF DOPMINE NEURON NUMBER IN BRAINR01NS019788 · NINDS · NATHAN S. KLINE INSTITUTE FOR PSYCH RES · PI VADASZ, CSABA · 1985 to 1988
–
NINDS NIH HHS R01 NS019788NINDS NIH HHS UH3 NS103549
6 · The paper itself

Abstract

backgroundWhen evaluating deep brain stimulation (DBS) for newer indications, patients may benefit from trial stimulation prior to permanent implantation or for investigatory purposes. Although several case series have evaluated infectious complications among DBS patients who underwent trials with external hardware, outcomes have been inconsistent.

objectiveTo determine whether a period of lead externalization is associated with an increased risk of infection.

methodsWe conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses compliant systematic review of all studies that included rates of infection for patients who were externalized prior to DBS implantation. A meta-analysis of proportions was performed to estimate the pooled proportion of infection across studies, and a meta-analysis of relative risks was conducted on those studies that included a control group of nonexternalized patients. Heterogeneity across studies was assessed via I2 index.

resultsOur search retrieved 23 articles, comprising 1354 patients who underwent lead externalization. The pooled proportion of infection was 6.9% (95% CI: 4.7%-9.5%), with a moderate to high level of heterogeneity between studies (I2 = 62.2%; 95% CI: 40.7-75.9; P < .0001). A total of 3 studies, comprising 212 externalized patients, included a control group. Rate of infection in externalized patients was 5.2% as compared to 6.0% in nonexternalized patients. However, meta-analysis was inadequately powered to determine whether there was indeed no difference in infection rate between the groups.

conclusionThe rate of infection in patients with electrode externalization is comparable to that reported in the literature for DBS implantation without a trial period. Future studies are needed before this information can be confidently used in the clinical setting.

Indexed as

Deep Brain StimulationBrainElectrodesHumansAdverse eventsComplicationsDeep brain stimulationExternalizationInfection

Identifiers

PMID32895713
PMCPMC8324247

What OpenQuestion holds

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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.