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Glycerol For Stroke Fails To Produce Long-Term Survival
A DGReview of :"Glycerol for acute stroke: a Cochrane systematic review"
Journal of Neurology
05/09/2002
By Robert Short
The use of glycerol treatment routinely in patients with acute stroke is not supported by evidence of benefit in long-term survival.
This is the overall conclusion of a Cochrane systematic review of the evidence on the use of glycerol in acute stroke. Dr Enrico Righetti, Servizio Malattie Cerebrovascolari, Perugia, Italy, and colleagues undertook a systematic review of the evidence on the use of glycerol and its influence on death.
Ten trials were suitable for analysis of short-term death for acute ischaemic and/or haemorrhagic stroke: 482 glycerol-treated patients were compared with 463 control patients. Glycerol is a hyperosmolar agent that has been claimed to reduce brain oedema.
The researchers found that it was associated with a non-significant reduction in the odds of death within the scheduled treatment period. But, there was no significant reduction at the end of the scheduled follow-up period.
Dr Righetti said, "This systematic review suggests a favourable effect of glycerol treatment on short-term survival in probable or definite ischaemic stroke, but the magnitude of the treatment effect may be minimal ( as low as 3 percent reduction in odds)."
He cautioned that there were a small number of patients in suitable trials for the analysis and that the studies were performed prior to the existence of CT. Therefore, the results should be interpreted cautiously. He concluded, "The lack of evidence of benefit in long-term survival does not support the routine or selective use of glycerol treatments in patients with acute stroke."
Journal of Neurology 2002;249(4):445-451.
"Glycerol for acute stroke: a Cochrane systematic review"
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