External drains versus no drains after burr‐hole evacuation for the treatment of chronic subdural haematoma in adults

Deqing Peng<sup>a</sup>; Yongjian Zhu<sup>a</sup>

doi:10.1002/14651858.CD011402.pub2

Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados
Respuestas clínicas Cochrane
Guías
Temas

Revisiones y protocolos relacionados

Respuestas clínicas Cochrane

Topics

Temas

Figure 1

Study flow diagram

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies. Nine studies are included in this review.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.1

Comparison 1 Comparison of drains versus no drains, Outcome 1 Recurrence.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1 Comparison of drains versus no drains, Outcome 2 Complications.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.3

Comparison 1 Comparison of drains versus no drains, Outcome 3 Mortality.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.4

Comparison 1 Comparison of drains versus no drains, Outcome 4 Poor functional outcome.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.5

Comparison 1 Comparison of drains versus no drains, Outcome 5 Sensitivity analysis of recurrence.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Summary of findings for the main comparison. Drains compared to no drains for burr‐hole evacuation of CSDH in adults

Drains compared to no drains for burr‐hole evacuation of CSDH in adults
Patient or population: adults with burr‐hole evacuation of CSDH Settings: hospital settings in India,Turkey, Iran, Germany, UK and Japan Intervention: one or more drains Comparison: no drains
Outcomes	*Illustrative comparative risks (95% CI)**		Relative effect (95% CI)	No of Participants (studies)	Quality of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	No drain	Drain
Overall recurrence Follow‐up: 3 weeks‐6 months	Study population		RR 0.45 (0.32 to 0.61)	968 (9 studies)	⊕⊕⊕⊝ moderate¹
	216 per 1000	97 per 1000 (69 to 132)
	Moderate
	231 per 1000	104 per 1000 (74 to 141)
Recurrence with 2 burr holes (subgroup) Follow‐up: 6 months	Study population		RR 0.46 (0.26 to 0.8)	306 (3 studies)	⊕⊕⊝⊝ low^1,2
	216 per 1000	99 per 1000 (56 to 173)
	Moderate
	231 per 1000	106 per 1000 (60 to 185)
Recurrence with 1 burr hole (subgroup) Follow‐up: 6 months	Study population		RR 0.17 (0.05 to 0.56)	156 (2 studies)	⊕⊕⊝⊝ low^1,2
	211 per 1000	36 per 1000 (11 to 118)
	Moderate
	213 per 1000	36 per 1000 (11 to 119)
Recurrence with 1 or 2 burr holes (subgroup) Follow‐up: 3 weeks‐6 months	Study population		RR 0.52 (0.34 to 0.79)	506 (4 studies)	⊕⊕⊕⊝ moderate¹
	218 per 1000	113 per 1000 (74 to 172)
	Moderate
	213 per 1000	111 per 1000 (72 to 168)
Complications Follow‐up: 3 weeks‐6 months	Study population		RR 1.15 (0.77 to 1.72)	710 (7 studies)	⊕⊕⊝⊝ low^1,2
	110 per 1000	127 per 1000 (85 to 190)
	Moderate
	100 per 1000	115 per 1000 (77 to 172)
Mortality Follow‐up: 6 months	Study population		RR 0.78 (0.45 to 1.33)	539 (5 studies)	⊕⊕⊝⊝ low^1,2
	100 per 1000	78 per 1000 (45 to 133)
	Moderate
	56 per 1000	44 per 1000 (25 to 74)
Poor functional outcome (includes death) Follow‐up: 6 months	Study population		RR 0.68 (0.44 to 1.05)	490 (5 studies)	⊕⊕⊝⊝ low^1,2
	169 per 1000	115 per 1000 (74 to 177)
	Moderate
	131 per 1000	89 per 1000 (58 to 138)
The basis for the assumed risk* (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.
¹ Only one trial used adequate allocation concealment, and one trial used alternation as a randomisation method (Wakai 1990). ² Downgraded one level for imprecision: estimate based on few events and wide CIs.

Summary of findings for the main comparison. Drains compared to no drains for burr‐hole evacuation of CSDH in adults

Ir a la tabla de la revisión

Comparison 1. Comparison of drains versus no drains

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Recurrence Show forest plot	9	968	Risk Ratio (M‐H, Fixed, 95% CI)	0.45 [0.32, 0.61]

1.1 Two holes	3	306	Risk Ratio (M‐H, Fixed, 95% CI)	0.46 [0.26, 0.80]
1.2 One hole	2	156	Risk Ratio (M‐H, Fixed, 95% CI)	0.17 [0.05, 0.56]
1.3 One or two holes	4	506	Risk Ratio (M‐H, Fixed, 95% CI)	0.52 [0.34, 0.79]
2 Complications Show forest plot	7	710	Risk Ratio (M‐H, Fixed, 95% CI)	1.15 [0.77, 1.72]

3 Mortality Show forest plot	5	539	Risk Ratio (M‐H, Fixed, 95% CI)	0.78 [0.45, 1.33]

4 Poor functional outcome Show forest plot	5	490	Risk Ratio (M‐H, Fixed, 95% CI)	0.68 [0.44, 1.05]

5 Sensitivity analysis of recurrence Show forest plot	7	802	Risk Ratio (M‐H, Fixed, 95% CI)	0.33 [0.22, 0.50]

Comparison 1. Comparison of drains versus no drains

Ir a la tabla de la revisión

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Idioma de la Revisión Cochrane

Idioma de la web

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet