Neurogenic pulmonary edema (NPE) is a life-threatening and severe complication in patients with spontaneous subarachnoid hemorrhage (SAH). The prevalence of NPE varies significantly across studies due to differences in case definitions, study populations, and methodologies. Therefore, a precise estimation of the prevalence and risk factors related to NPE in patients with spontaneous SAH is important for clinical decision-makers, policy providers, and researchers. We conducted a systematic search of the PubMed/Medline, Embase, Web of Science, Scopus, and Cochrane Library databases from their inception to January 2023. Thirteen studies were included in the meta-analysis, with a total of 3,429 SAH patients. The pooled global prevalence of NPE was estimated to be 13%. Out of the eight studies (n = 1095, 56%) that reported the number of in-hospital mortalities of NPE among patients with SAH, the pooled proportion of in-hospital deaths was 47%. Risk factors associated with NPE after spontaneous SAH included female gender, WFNS class, APACHE II score ≥ 20, IL-6 > 40 pg/mL, Hunt and Hess grade ≥ 3, elevated troponin I, elevated white blood cell count, and electrocardiographic abnormalities. Multiple studies showed a strong positive correlation between the WFNS class and NPE. In conclusion, NPE has a moderate prevalence but a high in-hospital mortality rate in patients with SAH. We identified multiple risk factors that can help identify high-risk groups of NPE in individuals with SAH. Early prediction of the onset of NPE is crucial for timely prevention and early intervention.

神经源性肺水肿（NPE）是自发性蛛网膜下腔出血（SAH）患者的一种危及生命的严重并发症。由于病例定义、研究人群和方法的差异，NPE 的患病率在不同研究中存在显着差异。因此，准确估计自发性 SAH 患者中 NPE 的患病率和危险因素对于临床决策者、政策提供者和研究人员来说非常重要。我们对 PubMed/Medline、Embase、Web of Science、Scopus 和 Cochrane 图书馆数据库从建库到 2023 年 1 月期间进行了系统检索。荟萃分析中纳入了 13 项研究，共计 3,429 名 SAH 患者。全球 NPE 合并患病率估计为 13%。 在报告 SAH 患者 NPE 院内死亡人数的8 项研究（ n = 1095，56%）中，院内死亡的汇总比例为 47%。自发性SAH后与NPE相关的危险因素包括女性、WFNS分级、APACHE II评分≥20、IL-6>40pg/mL、Hunt和Hess分级≥3、肌钙蛋白I升高、白细胞计数升高和心电图异常。多项研究表明 WFNS 类别与 NPE 之间存在很强的正相关性。总之，SAH 患者 NPE 患病率中等，但院内死亡率较高。我们确定了多种风险因素，可以帮助识别 SAH 患者中 NPE 的高危人群。早期预测NPE的发病对于及时预防和早期干预至关重要。