Journal
QUANTITATIVE IMAGING IN MEDICINE AND SURGERY
Volume 8, Issue 4, Pages 421-432Publisher
AME PUBL CO
DOI: 10.21037/qims.2018.05.07
Keywords
Posterior reversible encephalopathy syndrome (PRES); hemorrhage; outcome; meta-analysis
Funding
- National Natural Science Foundation of China [81471645]
- Shandong Provincial Key Research & Development Project [2015GSF118185]
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Background: The roles of clinical etiology and symptoms, imaging findings and biochemical parameters in predicting the prognosis of posterior reversible encephalopathy syndrome (PRES) have not been well-characterized. We perform a meta-analysis of all published studies to assess the value of various risk factors in predicting the prognosis of PRES. Methods: Searches of the PubMed, EMBASE, Cochrane Library, and Web of Science databases were performed to identify the eligible studies. The odds ratios (ORs) with their corresponding 95% confidence interval (CI) for related risk factors were used to calculate the pooled estimates of the outcomes. Results: Six studies with 448 cases were included in the meta-analysis. Hemorrhage was associated with high risk for poor outcome in patients with PRES. Toxemia of pregnancy (pre-eclampsia/eclampsia) was associated with improved outcome in PRES patients. Cytotoxic edema was noted to be related to poor outcome, but did not show statistical significance. The pooled OR for hemorrhage, pre-eclampsia/eclampsia, cytotoxic edema was 4.93 (95% CI: 3.94-6.17; P<0.00001), 0.24 (95% CI: 0.15-0.40; P<0.00001) and 2.59 (95% CI: 0.84-7.99; P=0.10), respectively. Conclusions: PRES patients with hemorrhage or cytotoxic edema are likely to have poor outcomes. Preeclampsia/ eclampsia is associated with reduced risk of poor outcome in patients with PRES.
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