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Abstract Details

The Long-term Functional Recovery Trajectory of Patients with Spontaneous Intracerebral Hemorrhage: A Systematic Review and Meta-analysis
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
079

Our study aims to to clarify the duration of functional improvements and the timing of recovery plateau among intracerebral hemorrhage (ICH) patients.
Although many studies have been published on the recovery trajectory (including timeline and degree of recovery) of ischemic strokes, the literature on ICH is much sparser. A better understanding of ICH recovery trajectory will help inform the design of future ICH treatment trials, ICH patient rehabilitation strategies, and healthcare resource allocation.
A systematic search was conducted in MEDLINE, Embase, CINAHL, OTSeeker, and PEDro for English language primary studies from January 1, 1970 through November 20, 2019. Two reviewers independently screened citations, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale and Cochrane Risk of Bias tool. Meta-analysis was performed using the Mantel-Haenszel method.
Of the 6,892 articles initially identified, 5,205 titles and abstracts were screened following duplicate removal. After full-text review of 95 articles, 16 citations were considered eligible for qualitative and quantitative synthesis, detailing the recovery of 12,350 subjects. Among 14 studies that included functional outcomes at 3- and 12-months post-stroke, “good outcomes”, as defined by the individual studies, were significantly more likely at the later time point, risk difference 0.029 (95% CI 0.010, 0.047), p=0.0054; heterogeneity was moderate (I2= 41%, tau2=0.0004). These results were consistent in a sensitivity analysis confined to studies defining good outcome as mRS of 0-2 (among 10 studies), risk difference 0.0359 (95% CI 0.0132, 0.0587), p=0.006. The methodological quality of the studies was identified to have low to moderate risk of bias.
ICH patients continue to make functional improvements beyond 3 months throughout the 1st year post-stroke. Future prospective studies are required to define patient characteristics that predict long-term recovery post ICH and identify whether there exists a plateau timepoint between 3 and 12 months.
Authors/Disclosures
Randi Mao
PRESENTER 		Miss Mao has nothing to disclose.
Lauren M. Mai, MD Dr. Mai has nothing to disclose.
Sebastian Fridman, MD (LHSC Western University) Dr. Fridman has nothing to disclose.
Ashkan Shoamanesh, MD Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer AG. Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Daiichi Sankyo . Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Servier Inc.. Dr. Shoamanesh has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurodiem.ca. The institution of Dr. Shoamanesh has received research support from Servier Canada Inc.. The institution of Dr. Shoamanesh has received research support from Daiichi Sankyo Ltd.. The institution of Dr. Shoamanesh has received research support from Bayer AG. The institution of Dr. Shoamanesh has received research support from Bristol-Myers Squibb. The institution of Dr. Shoamanesh has received research support from Octapharma Canada .