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A Systematic and Meta-Analysis of Mortality in Experimental Mouse Models Analyzing Delayed Cerebral Ischemia After Subarachnoid Hemorrhage

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Abstract

Animal models are established to display the pathophysiological changes following subarachnoid hemorrhage (SAH). The aim of the present study was to determine case fatality in mouse delayed cerebral ischemia (DCI) models, to compare mortality in mouse DCI models to case fatality in human SAH patients, and to identify factors influencing mouse mortality. A systematic search of the PubMed database was performed to identify all studies that assessed mouse DCI models. Mortality rates and predictor variables were extracted and compared to the human case fatality after SAH as previously reported. Predictors for mouse mortality were identified through multivariate analysis. Forty-eight studies were included in the quantitative analysis. The mean overall mortality rate was 21% in mouse DCI models. However, the time period between induction of SAH and evaluation of mortality rates is a significant variable influencing the mortality rate in mouse SAH models. The experimental SAH model was the only significant predictor for mouse mortality after 48 h. In contrast, neither the genetic background nor the anesthetic changed the case fatality rate. Mouse mortality at 24, 48, and 72 h after experimental SAH in DCI models was significantly lower than human case fatality following aneurysmal SAH. The mean overall mortality rate in mouse DCI models is significantly lower than human case fatality following aneurysmal SAH. However, time between SAH induction and evaluation is a significant variable influencing the mortality rate in mouse SAH models. Further analyses will be required to establish whether and to which extent different DCI models affect mortality and reflect human pathophysiology.

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Authors and Affiliations

  1. Department of Neurosurgery, Medical Faculty, Heinrich Heine University, Moorenstraße 5, 40225, Düsseldorf, Germany

    Marcel A. Kamp, Jasper H. van Lieshout, Maxine Dibué-Adjei, Jasmin K. Weber & Hans-Jakob Steiger

  2. Institute for Neurophysiology, Medical Faculty, University of Cologne, Robert-Koch-Str. 39, 50931, Köln, Germany

    Maxine Dibué-Adjei & Toni Schneider

  3. Zurich Center for Integrative Human Physiology, Institute of Physiology, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland

    Tanja Restin

  4. Institute of Anesthesiology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland

    Tanja Restin

  5. Division of Informatics and Statistics, Department of Neurosurgery, Medical Faculty, Heinrich Heine University, Moorenstraße 5, 40225, Düsseldorf, Germany

    Igor Fischer

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  1. Marcel A. Kamp
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Correspondence to Marcel A. Kamp.

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This article does not contain any studies with human participants or animals performed by any of the authors.

Funding

TR’s position is funded through the MD-PhD Program of the Swiss National Science Foundation (SNSF), Bern, Switzerland (323530_158128).

Conflict of Interest

Dr. Maxine Dibué-Adjei is an employee of the LivaNova PLC. All other authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in the speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Electronic supplementary material

Supplementary Figure 1

Funnel plot of mouse and human mortality after SAH. The supplementary Figure 1 shows Funnel plots of reported mouse (a) and human mortality (b) after SAH. (JPEG 35 kb)

Supplementary Figure 2

Decrease of human and mouse SAH-related mortality (%) over time. (JPEG 42 kb)

Supplementary Figure 3

Age, weight and mortality. The Supplementary Figure 3 shows the age (a) and weight (b) ranges of the included SAH mice and the related mortality rates. (JPEG 46 kb)

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Kamp, M.A., Lieshout, J.H.v., Dibué-Adjei, M. et al. A Systematic and Meta-Analysis of Mortality in Experimental Mouse Models Analyzing Delayed Cerebral Ischemia After Subarachnoid Hemorrhage. Transl. Stroke Res. 8, 206–219 (2017). https://doi.org/10.1007/s12975-016-0513-3

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  • DOI: https://doi.org/10.1007/s12975-016-0513-3

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