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Article: Early Magnesium Treatment after Aneurysmal Subarachnoid Hemorrhage: Individual Patient Data Meta-Analysis

TitleEarly Magnesium Treatment after Aneurysmal Subarachnoid Hemorrhage: Individual Patient Data Meta-Analysis
Authors
Keywordsbrain ischemia
magnesium
meta-analysis
stroke
subarachnoid hemorrhage
Issue Date2015
Citation
Stroke, 2015, v. 46, n. 11, p. 3190-3193 How to Cite?
AbstractBackground and Purpose-Delayed cerebral ischemia (DCI) is an important cause of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). Trials of magnesium treatment starting <4 days after symptom onset found no effect on poor outcome or DCI in SAH. Earlier installment of treatment might be more effective, but individual trials had not enough power for such a subanalysis. We performed an individual patient data meta-analysis to study whether magnesium is effective when given within different time frames within 24 hours after the SAH. Methods-Patients were divided into categories according to the delay between symptom onset and start of the study medication: <6, 6 to 12, 12 to 24, and >24 hours. We calculated adjusted risk ratios with corresponding 95% confidence intervals for magnesium versus placebo treatment for poor outcome and DCI. Results-We included 5 trials totaling 1981 patients; 83 patients started treatment <6 hours. For poor outcome, the adjusted risk ratios of magnesium treatment for start <6 hours were 1.44 (95% confidence interval, 0.83-2.51); for 6 to 12 hours 1.03 (0.65-1.63), for 12 to 24 hours 0.84 (0.65-1.09), and for >24 hours 1.06 (0.87-1.31), and for DCI, <6 hours 1.76 (0.68-4.58), for 6 to 12 hours 2.09 (0.99-4.39), for 12 to 24 hours 0.80 (0.56-1.16), and for >24 hours 1.08 (0.88-1.32). Conclusions-This meta-analysis suggests no beneficial effect of magnesium treatment on poor outcome or DCI when started early after SAH onset. Although the number of patients was small and a beneficial effect cannot be definitively excluded, we found no justification for a new trial with early magnesium treatment after SAH.
Persistent Identifierhttp://hdl.handle.net/10722/325301
ISSN
2023 Impact Factor: 7.8
2023 SCImago Journal Rankings: 2.450
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorDorhout Mees, Sanne M.-
dc.contributor.authorAlgra, Ale-
dc.contributor.authorWong, George K.C.-
dc.contributor.authorPoon, Wai S.-
dc.contributor.authorBradford, Celia M.-
dc.contributor.authorSaver, Jeffrey L.-
dc.contributor.authorStarkman, Sidney-
dc.contributor.authorRinkel, Gabriel J.E.-
dc.contributor.authorVan Den Bergh, Walter M.-
dc.date.accessioned2023-02-27T07:31:22Z-
dc.date.available2023-02-27T07:31:22Z-
dc.date.issued2015-
dc.identifier.citationStroke, 2015, v. 46, n. 11, p. 3190-3193-
dc.identifier.issn0039-2499-
dc.identifier.urihttp://hdl.handle.net/10722/325301-
dc.description.abstractBackground and Purpose-Delayed cerebral ischemia (DCI) is an important cause of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). Trials of magnesium treatment starting <4 days after symptom onset found no effect on poor outcome or DCI in SAH. Earlier installment of treatment might be more effective, but individual trials had not enough power for such a subanalysis. We performed an individual patient data meta-analysis to study whether magnesium is effective when given within different time frames within 24 hours after the SAH. Methods-Patients were divided into categories according to the delay between symptom onset and start of the study medication: <6, 6 to 12, 12 to 24, and >24 hours. We calculated adjusted risk ratios with corresponding 95% confidence intervals for magnesium versus placebo treatment for poor outcome and DCI. Results-We included 5 trials totaling 1981 patients; 83 patients started treatment <6 hours. For poor outcome, the adjusted risk ratios of magnesium treatment for start <6 hours were 1.44 (95% confidence interval, 0.83-2.51); for 6 to 12 hours 1.03 (0.65-1.63), for 12 to 24 hours 0.84 (0.65-1.09), and for >24 hours 1.06 (0.87-1.31), and for DCI, <6 hours 1.76 (0.68-4.58), for 6 to 12 hours 2.09 (0.99-4.39), for 12 to 24 hours 0.80 (0.56-1.16), and for >24 hours 1.08 (0.88-1.32). Conclusions-This meta-analysis suggests no beneficial effect of magnesium treatment on poor outcome or DCI when started early after SAH onset. Although the number of patients was small and a beneficial effect cannot be definitively excluded, we found no justification for a new trial with early magnesium treatment after SAH.-
dc.languageeng-
dc.relation.ispartofStroke-
dc.subjectbrain ischemia-
dc.subjectmagnesium-
dc.subjectmeta-analysis-
dc.subjectstroke-
dc.subjectsubarachnoid hemorrhage-
dc.titleEarly Magnesium Treatment after Aneurysmal Subarachnoid Hemorrhage: Individual Patient Data Meta-Analysis-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1161/STROKEAHA.115.010575-
dc.identifier.pmid26463689-
dc.identifier.scopuseid_2-s2.0-84945940511-
dc.identifier.volume46-
dc.identifier.issue11-
dc.identifier.spage3190-
dc.identifier.epage3193-
dc.identifier.eissn1524-4628-
dc.identifier.isiWOS:000363974500025-

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