Lumbar continuous drainage of cerebrospinal fluid for the efficacy of patients with spontaneous subarachnoid hemorrhage: a meta-analysis

Objective To evaluate the treatment effect of lumbar continuous drainage of cerebrospinal fluid for spontaneous subarachnoid hemorrhage. Methods Pubmed, Medline, Embase, Cochrane Library, CNKI, CBM, Wangfang, and VIP dadabase were retrieved with computers, and the cut-off time was March 2015. The related control studies were searched. A meta-analysis was performed using RevMan 5.3 software. Results A total of 20 studies and 2739 patients were enrolled. The results of meta-analysis showed that continuous lumbar cistern drainage of cerebrospinal fluid was superior to the routine therapy in the following aspects: the mortality during hospitalization (OR, 0.36; 95% CI 0.25-0.51; P<0.001), incidence of rebleeding (OR, 0.49; 95% CI 0.30-0.79; P<0.05), vasospasm (OR, 0.19; 95% CI 0.14-0.24; P<0.001), hydrocephalus (OR, 0.35; 95% CI 0.28-0.45; P<0.001), delayed ischemic neurological deficit (OR, 0.44; 95% CI 0.31-0.63; P<0.001), duration of headache in patients [WMD, -9.15; 95% CI -9.92, -8.39, P<0.001], and GOS scale score (WMD, 0.69; 95% CI 0.53-0.86; P<0.001). Conclusions Compared with the conventional treatment, the continuous lumbar cistern drainage of cerebrospinal fluid may decrease the mortality, incidence of rebleeding, vasospasm, hydrocephalus, and the occurrence of delayed ischemic neurological deficit in patients. At the same time, the headache duration of the patients can be decrease significantly and the GOS scores can be increased significantly. Key words: Cerebrospinal fluid; Drainage; Subarachnoid hemorrhage; Meta-analysis