SynthesisBMJ open2020
Prompt closure versus gradual weaning of external ventricular drainage for hydrocephalus in adult patients with aneurysmal subarachnoid haemorrhage: a systematic review.
Synthesis in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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.
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.
Who cites it
10 citing papers in PubMed, 22 citations in OpenAlex.
- Current Management of Aneurysmal Subarachnoid Hemorrhage.Neurology international · 2025Review
- Research priorities for improving cognitive and neuropsychological outcomes in hydrocephalus.Fluids and barriers of the CNS · 2024Review
- Proteomic profile and predictive markers of outcome in patients with subarachnoid hemorrhage.Clinical proteomics · 2024Article
- Management of external ventricular drain: to wean or not to wean?Acta neurochirurgica · 2024Article
- Article
- A comparison of ventricular volume and linear indices in predicting shunt dependence in aneurysmal subarachnoid hemorrhage.World neurosurgery: X · 2023Article
- Inflammatory Markers as Predictors of Shunt Dependency and Functional Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage.Biomedicines · 2023Article
- Chinese expert consensus on the management of aneurysmal subarachnoid hemorrhage-related hydrocephalus.Chinese neurosurgical journal · 2023Article
- External Ventricular Drains: Development and Evaluation of a Nursing Clinical Practice Guideline.Nursing reports (Pavia, Italy) · 2022Article
- Quality assessment of evidence must be stated in conclusions to avoid conveying questionable recommendations.Neurosurgical review · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo summarise the evidence on benefits and harms of prompt closure versus gradual weaning of external ventricular drainage (EVD) in patients with hydrocephalus following aneurysmal subarachnoid haemorrhage (aSAH) based on randomised clinical trials (RCTs) in humans.
settingRCTs comparing prompt closure versus gradual weaning of EVD in adult patients with hydrocephalus following aSAH were included.
participantsPatients aged equal to or greater than 18 years with an EVD due to hydrocephalus following aSAH were eligible for inclusion. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes were all-cause mortality, any serious adverse event, rate of ventriculoperitoneal (VP) shunt placement and quality of life. Secondary outcomes were patients with shunt failure, hospital and neuro intensive care unit (NICU) length of stay (LOS) and complications related to treatment with an EVD. Data permitted report of rate of VP shunt placement, and hospital and NICU LOS.
resultsSix studies were assessed in full text. One RCT with 81 patients was included. Rate of VP shunt placement was 63.4% in the rapid weaning group (ie, prompt closure of the EVD; 41 patients) and 62.5% in the gradual weaning group (40 patients; p=0.932). LOS in hospital and NICU was significantly shorter in the rapidly weaned group compared with the gradually weaned group (mean 19.1 vs 21.5 days in hospital (p=0.03); and mean 14.1 vs 16.9 days in NICU (p=0.0002)). Data were insufficient to conduct meta-analysis, trial sequential analysis or subgroup analysis of heterogeneity and sensitivity. One RCT is currently ongoing.
conclusionsWe found insufficient evidence to favour any of the two strategies for EVD discontinuation in patients with hydrocephalus following aSAH. PROSPERO REGISTRATION NUMBER: CRD42018108801.
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Registered trials
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