Hydrocephalus after subarachnoid hemorrhage: A meta-analytic comparison of aneurysm treatments

Table 1 Series used for analysis

Series	Trial type	Treatment	No. of cases	Hydrocephalus incidence
Akyuz et al[21]	Ret	Clip	145	6.9%
Andaluz et al[22]	Pro	Clip	106	6.6%
Auer et al[23]	Ret	Clip	138	6.5%
Bailes et al[24]	Ret	Clip	27	96.3%
Chan et al[25]	Ret	Clip	89	57.3%
de Oliveira et al[26]	Ret	Clip	212	17.5%
Dehdashti et al[12]	Cohort	Both	245	13.9%
Diaz et al[27]	Ret	Coil	31	15.5%
Dorai et al[28]	Ret	Clip	651	23.3%
Fanning et al[29]	Ret	Coil	178	1.7%
Ferch et al[30]	Ret	Clip	73	53.4%
Fujimura et al[31]	Ret	Clip	39	17.9%
Fukuhara et al[32]	Pro	Clip	62	9.7%
Gao et al[33]	Ret	Coil	221	4.1%
Gilsbach et al[34]	Ret	Clip	138	23.2%
Graff-Radford et al[35]	Ret	Clip	3521	8.9%
Gruber et al[36]	Ret	Both	187	21.4%
Harrigan et al[37]	Ret	Both	349	41.2%
Hernesniemi et al[38]	Ret	Clip	57	31.6%
Hirashima et al[39]	Ret	Clip	114	34.2%
Hoh et al[40]	Ret	Both	20585	5.4%
Hornyak et al[41]	Ret	Clip	92	20.7%
Jartti et al[42]	Ret	Both	209	30.1%
Joakimsen et al[43]	Pro	Clip	47	10.6%
Kaku et al[44]	Ret	Both	100	18.0%
Kang et al[45]	Pro	Coil	76	5.3%
Kasuya et al[46]	Ret	Clip	108	29.6%
Kolluri et al[47]	Ret	Clip	500	4.2%
Komotar et al[48]	Ret	Clip	582	10.3%
Krayenbühll et al[49]	Ret	Clip	218	10.1%
Kung et al[50]	Ret	Coil	102	30.4%
Kwon et al[51]	Ret	Coil	107	12.1%
Liew et al[52]	Ret	Clip	13	69.2%
Lin et al[53]	Ret	Clip	147	15.6%
Milhorat et al[54]	Ret	Clip	29	20.7%
Moriyama et al[55]	Ret	Clip	58	32.8%
Nam et al[56]	Ret	Both	736	19.7%
Natarajan et al[57]	Ret	Both	192	14.3%
Ohwaki et al[58]	Ret	Clip	74	33.8%
O'Kelly et al[59]	Ret	Both	3120	18.7%
Park et al[60]	Ret	Clip	94	13.8%
Park et al[61]	Ret	Coil	118	5.9%
Pinsker et al[62]	Ret	Clip	31	48.4%
Raimondi et al[63]	Ret	Clip	30	13.3%
Säveland et al[64]	Pro	Clip	247	1.2%
Schmieder et al[65]	Ret	Clip	138	10.9%
Sethi et al[66]	Ret	Both	100	6.0%
Sindou et al[67]	Ret	Clip	197	12.7%
Spallone et al[68]	Ret	Clip	125	7.2%
Stenhouse et al[69]	Ret	Clip	27	11.1%
Sundt et al[70]	Ret	Clip	616	9.4%
Taha et al[71]	Ret	Both	133	22.5%
Tapaninaho et al[72]	Ret	Clip	835	9.7%
Theander et al[73]	Ret	Clip	16	6.3%
Tomasello et al[74]	Pro	Clip	47	4.3%
Tsementzis et al[75]	Pro	Clip	61	6.6%
Vale et al[76]	Ret	Clip	90	20.0%
Vanninen et al[11]	RCT	Both	106	13.2%
Varelas et al[77]	Ret	Both	163	7.3%
Vassilouthis et al[78]	Ret	Clip	181	6.1%
Widenka et al[79]	Ret	Clip	283	18.4%
Williams et al[80]	Ret	Clip	19	42.1%
Yang et al[81]	Ret	Both	88	25.0%
Yasui et al[82]	Ret	Clip	82	46.3%
Yoshioka et al[83]	Ret	Clip	576	37.3%

RCT: Randomized controlled trial; Pro: Prospective data collection; Ret: Retrospective; Clip: Microvascularapproach; Coil: Endovascular approach; Both: Clipping and coiling procedures reported in series.

Table 2 Risk ratios by study type

Study type	Number of studies	Risk ratio(coil/clip)	95%CI
RCT	1	0.286	0.008-1.011
Cohort study	1	1.512	0.956-2.068
All comparative studies	14	1.150	0.982-1.318
Observational studies	65	0.770	0.539-1.005

RCT: Randomized controlled trial; Clip: Microvascularapproach; Coil: Endovascular approach.

Table 3 Association between variables and incidence of hydrocephalus

Variable	B coefficient	95%CI	P value
Treatment1	-0.048	-0.131-0.034	0.249
Mean hunt-hess grade	0.146	0.064-0.228	0.001
Mean fisher grade	0.015	-0.106-0.136	0.805
Mean age (yr)	0.010	0.002-0.018	0.019
% Female patients	-0.047	-0.544-0.451	0.852
% Vertebrobasilar aneurysms	0.001	-0.002-0.004	0.434
Time to treatment	-0.011	-0.021-0.0004	0.042
Duration of follow-up	-0.000	-0.004-0.003	0.833
Year of publication	0.001	-0.002-0.005	0.455

¹Clipping scored 1, coiling 2.