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논문분류	춘계학술대회 초록집
제목	LOW GLOMERULAR FILTRATION RATE IS ASSOCIATED WITH HEMORRHAGIC TRANSFORMATION IN ACUTE ISCHEMIC STROKE PATIENTS: A META-ANALYSIS
저자	Gaurav Nepal, Saurav Dahal, Sushil Yadav
출판정보	2019; 2019(1):
키워드	Hemorrhagic transformation \| GLOMERULAR FILTRATION RATE \| Stroke
초록	Acute Ischemic Stroke (AIS) is one of the leading cause of death, premature death, and disability globally. Hemorrhagic transformation (HT) is a common complication of AIS and is related to higher mortality, early neurological deterioration, and worse long‑term functional outcome. Numerous observational studies have been published but the relationship between low eGFR level and HT in AIS patients is still controversial. We sought to do a meta-analysis to determine the association between low eGFR level and HT in AIS. We searched multiple electronic databases to identify studies published from 1990 to 2018. Following the application of inclusion and exclusion criteria, the ORs and 95% CIs of all the included studies were employed to estimate the pooled OR and 95% CI using the inverse variance random-effects method. Publication bias was assessed through Egger's test and Begg test. Heterogeneity was assessed by means of the I-squared value. Ten observational studies including 4,653 AIS patients contributed to the analysis. Low eGFR level significantly increased the risk of HT in AIS patients (OR=1.60, 95% CI: 1.21–2.1, P = 0.001). Significant heterogeneity was seen among studies (I2 = 45%, p = 0.06). No evidence of publication bias was observed in this meta-analysis. The effect size was stable during sensitivity analysis. We found no subgroup difference based on study design, study population, AIS type, stroke treatment, and study site. Our study showed that low eGFR increases the risk of HT. Our study had significant heterogeneity, as a consequence, the results of our meta-analysis should be interpreted with caution. Clinicians managing AIS patients should pay attention to renal insufficiency for preventing HT after AIS. In-depth laboratory studies are warranted to find out the mechanisms that could explain the association between renal insufficiency and HT.
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