TY - JOUR
T1 - Fibrinolytic for treatment of intraventricular hemorrhage
T2 - A meta-analysis and systematic review
AU - Baker, Alexandra Delaney
AU - Rivera Perla, Krissia Margarita
AU - Yu, Zhiyuan
AU - Dlugash, Rachel
AU - Avadhani, Radhika
AU - Mould, William Andrew
AU - Ziai, Wendy
AU - Thompson, Richard E.
AU - Staykov, Dimitre
AU - Hanley, Daniel F.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: CLEAR III was supported by grant 5U01 NS062851-05, awarded to Dr. Daniel Hanley by the National Institute of Neurological Disorders and Stroke (NINDS), part of National Institutes of Health (NIH). Dr. Hanley is also supported by MISITE 4U01 NS080824-04 (NINDS) and Trial Innovation Center 1U24 TR001609-01 (NCATS).
Publisher Copyright:
© 2017 World Stroke Organization.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: Intraventricular hemorrhage is a significant cause of mortality and morbidity worldwide. Treating intraventricular hemorrhage with intraventricular fibrinolytic therapy via a catheter is becoming an increasingly utilized intervention. Aims: This meta-analysis aimed to investigate the role of intraventricular fibrinolytic treatment in hypertensive intraventricular hemorrhage patients and evaluate the effect sizes for survival as well as level of function at differing time points. Summary of review: PubMed, CNKI, VIP, and Wanfang were searched using the terms “IVH” and “IVH and ICH” for human studies with adult patients published between January 1950 and July 2016. Seventeen publications were selected. Data analysis showed lower rates of mortality in the treatment group at 30 days (P < 0.001), 180 days (P = 0.001), 365 days (P = 0.40), and overall (P < 0.001). Pooling modified Rankin Scale and Glasgow outcome scale data, the treatment group had more good functional outcomes at 30 days (P = 0.38), 90 days (P = 0.04), 180 days (P = 0.31), 365 days (P = 0.76), and overall (P = 0.02). Good functional outcome was defined as modified Rankin Scale score of 0 to 3 or a Glasgow outcome scale score of 3 to 5. Conclusions: Intraventricular fibrinolytic for treatment of hypertensive intraventricular hemorrhage reduces mortality and potentially leads to an increased number of good functional outcomes. Different functional outcome scales (modified Rankin Scale or Glasgow outcome scale) produce different effect sizes. Intraventricular fibrinolytic treatment may offer intraventricular hemorrhage patients a targeted therapy that produces meaningful mortality benefit and possible functional outcome benefits.
AB - Background: Intraventricular hemorrhage is a significant cause of mortality and morbidity worldwide. Treating intraventricular hemorrhage with intraventricular fibrinolytic therapy via a catheter is becoming an increasingly utilized intervention. Aims: This meta-analysis aimed to investigate the role of intraventricular fibrinolytic treatment in hypertensive intraventricular hemorrhage patients and evaluate the effect sizes for survival as well as level of function at differing time points. Summary of review: PubMed, CNKI, VIP, and Wanfang were searched using the terms “IVH” and “IVH and ICH” for human studies with adult patients published between January 1950 and July 2016. Seventeen publications were selected. Data analysis showed lower rates of mortality in the treatment group at 30 days (P < 0.001), 180 days (P = 0.001), 365 days (P = 0.40), and overall (P < 0.001). Pooling modified Rankin Scale and Glasgow outcome scale data, the treatment group had more good functional outcomes at 30 days (P = 0.38), 90 days (P = 0.04), 180 days (P = 0.31), 365 days (P = 0.76), and overall (P = 0.02). Good functional outcome was defined as modified Rankin Scale score of 0 to 3 or a Glasgow outcome scale score of 3 to 5. Conclusions: Intraventricular fibrinolytic for treatment of hypertensive intraventricular hemorrhage reduces mortality and potentially leads to an increased number of good functional outcomes. Different functional outcome scales (modified Rankin Scale or Glasgow outcome scale) produce different effect sizes. Intraventricular fibrinolytic treatment may offer intraventricular hemorrhage patients a targeted therapy that produces meaningful mortality benefit and possible functional outcome benefits.
KW - Glasgow Outcome Scale
KW - Intraventricular hemorrhage
KW - alteplase
KW - functional outcome
KW - intraventricular fibrinolytic
KW - modified Rankin Scale
KW - mortality
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U2 - 10.1177/1747493017730745
DO - 10.1177/1747493017730745
M3 - Review article
C2 - 28920538
AN - SCOPUS:85038232602
SN - 1747-4930
VL - 13
SP - 11
EP - 23
JO - International Journal of Stroke
JF - International Journal of Stroke
IS - 1
ER -