Adult internal cerebrospinal fluid shunt overall survival. A meta-analysis of restricted mean survival times from reconstructed Kaplan-Meier data.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-10-23 DOI:10.1016/j.wneu.2024.10.057

Charles Champeaux Depond, Roch Giorgi, Vincent Jecko, Philippe Metellus

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Abstract

Objective: To assess the overall survival (OS) of internal cerebrospinal fluid shunt (ICSFS) in the adult population.

Methods: Medline database was searched from 2000 to 2023 to identify studies reporting on ICSFS OS. Only articles reporting on adult ICSFS OS by a Kaplan-Meier (KM) OS curve were included. Numerical data were extracted from KM curves and, were then reconstructed to estimate 3, 6, 9, 12, 18, 24, 36, 48 and 60 months restricted mean survival times (RMST). RMST of ICSFS and its standard error (SE) at each time of interest were used as summary measure and primary outcome across studies. To account for the effect of between-study heterogeneity, RMST were pooled using a random effects model.

Results: Out of 421 screened studies, solely 6 were included in the meta-analysis. Calculated ICSFS OS at 3, 6, 12, 18, 24, 36, 48 and 60 months were 92.4%, _95%CI[89.6-95.2]; 89.5%, _95%CI[86.3-92.8]; 87.5%, _95%CI[83.9-91.1]; 85.2%, _95%CI[80.4-90.0]; 83.4%, _95%CI[79.0-87.9]; 81.6%, _95%CI[76.7-86.5]; 78.8%, _95%CI[72.9-84.6]; 76.7%, _95%CI[70.3-83.1]; 74.5%, _95%CI[67.8-81.1] respectively. There was a significant heterogeneity as indicated by a high I² of 82.5%, _95%CI[63.1-91.7]. Heterogeneity test of Q=28.63 was also significant (p-value<0.001).

Conclusions: On contrary to what one might think, there are few available studies assessing adult ICSFS OS. We used a novel technique to meta-analyse adult ICSFS OS. ICSFS failure rate is maximal within the 3 to 6 post-operative months. Afterwards, the risk slowly decrease over time. At 5 years, less than three quarters of the patients still have a naïve functional ICSFS never revised.

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成人体内脑脊液分流术总生存率。根据重建的 Kaplan-Meier 数据对受限平均存活时间进行荟萃分析。

目的：评估成人脑脊液内分流术（ICSFS）的总生存率（OS）：评估成人体内脑脊液分流术（ICSFS）的总生存率（OS）：方法：检索 2000 年至 2023 年的 Medline 数据库，以确定报告 ICSFS OS 的研究。仅纳入通过 Kaplan-Meier (KM) OS 曲线报告成人 ICSFS OS 的文章。从 KM 曲线中提取数字数据，然后进行重构，以估算 3、6、9、12、18、24、36、48 和 60 个月的限制性平均生存时间（RMST）。ICSFS的RMST及其在每个相关时间的标准误差（SE）被用作汇总指标和各研究的主要结果。为考虑研究间异质性的影响，采用随机效应模型对 RMST 进行汇总：在筛选出的 421 项研究中，只有 6 项纳入了荟萃分析。计算出的 3、6、12、18、24、36、48 和 60 个月的 ICSFS OS 分别为 92.4%，95%CI[89.6-95.2]；89.5%，95%CI[86.3-92.8]；87.5%，95%CI[83.9-91.1]；85.2%，95%CI[80.4-90.0]；83.4%，95%CI[79.0-87.9]；81.6%，95%CI[76.7-86.5]；78.8%，95%CI[72.9-84.6]；76.7%，95%CI[70.3-83.1]；74.5%，95%CI[67.8-81.1]。I2高达82.5%，95%CI[63.1-91.7]，表明存在明显的异质性。异质性检验的 Q=28.63 也具有显著性（p 值）：与人们的想象相反，目前评估成人 ICSFS OS 的研究很少。我们采用一种新技术对成人 ICSFS OS 进行了元分析。术后 3-6 个月内，ICSFS 的失败率最高。之后，随着时间的推移，风险会慢慢降低。5 年后，仍有不到四分之三的患者从未修改过 ICSFS 的原始功能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.

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