Scopus
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The Effect of Tranexamic Acid on Neurosurgical Intervention in Spontaneous Intracerebral Hematoma: Data from 121 Surgically Treated Participants from the Tranexamic Acid in IntraCerebral Hemorrhage-2 Randomized Controlled Trial
Neurosurgery · Eylül 2024
YÖKSİS Kayıtları
The Effect of Tranexamic Acid on Neurosurgical Intervention in Spontaneous Intracerebral Hematoma: Data From 121 Surgically Treated Participants From the Tranexamic Acid in IntraCerebral Hemorrhage-2 Randomized Controlled Trial
Neurosurgery · 2024 SCI-Expanded
PROFESÖR ŞEREFNUR ÖZTÜRK →
Makale Bilgileri
DergiNeurosurgery
Yayın TarihiEylül 2024
Cilt / Sayfa95 · 605-616
Scopus ID2-s2.0-85201438518
Erişim🔓 Açık Erişim
Özet
BACKGROUND AND OBJECTIVES: An important proportion of patients with spontaneous intracerebral hemorrhage (ICH) undergo neurosurgical intervention to reduce mass effect from large hematomas and control the complications of bleeding, including hematoma expansion and hydrocephalus. The Tranexamic acid (TXA) for hyperacute primary IntraCerebral Hemorrhage (TICH-2) trial demonstrated that tranexamic acid (TXA) reduces the risk of hematoma expansion. We hypothesized that TXA would reduce the frequency of surgery (primary outcome) and improve functional outcome at 90 days in surgically treated patients in the TICH-2 data set. METHODS: Participants enrolled in TICH-2 were randomized to placebo or TXA. Participants randomized to either TXA or placebo were analyzed for whether they received neurosurgery within 7 days and their characteristics, outcomes, hematoma volumes (HVs) were compared. Characteristics and outcomes of participants who received surgery were also compared with those who did not. RESULTS: Neurosurgery was performed in 5.2% of participants (121/2325), including craniotomy (57%), hematoma drainage (33%), and external ventricular drainage (21%). The number of patients receiving surgery who received TXA vs placebo were similar at 4.9% (57/1153) and 5.5% (64/1163), respectively (odds ratio [OR] 0.893; 95% CI 0.619-1.289; P-value =.545). TXA did not improve outcome compared with placebo in either surgically treated participants (OR 0.79; 95% CI 0.30-2.09; P =.64) or those undergoing hematoma evacuation by drainage or craniotomy (OR 1.19 95% 0.51-2.78; P-value =.69). Postoperative HV was not reduced by TXA (mean difference -8.97 95% CI -23.77, 5.82; P-value =.45). CONCLUSION: TXA was not associated with less neurosurgical intervention, reduced HV, or improved outcomes after surgery.
Yazarlar (19)
1
Milo Hollingworth
ORCID: 0000-0002-0669-2314
2
Lisa J. Woodhouse
ORCID: 0000-0002-4472-1999
3
Zhe K. Law
ORCID: 0000-0002-7900-9037
4
Azlinawati Ali
ORCID: 0000-0002-8443-4214
5
Kailash Krishnan
ORCID: 0000-0002-6486-3783
6
Robert A. Dineen
ORCID: 0000-0002-9523-2546
7
Hanne Christensen
ORCID: 0000-0002-7472-3194
8
Timothy J. England
9
Christine Roffe
ORCID: 0000-0002-5259-6649
10
David Werring
ORCID: 0000-0003-2074-1861
11
Nils Peters
12
Alfonso Ciccone
ORCID: 0000-0002-4590-3575
13
Thompson Robinson
ORCID: 0000-0003-2144-2468
14
Anna Członkowska
15
Dániel Bereczki
16
Juan José Egea-Guerrero
17
Şerefnur Öztürk
18
Philip M. Bath
19
Nikola Sprigg
ORCID: 0000-0002-5871-8168
Anahtar Kelimeler
Intracerebral hemorrhage
Neurosurgery
Stroke
Tranexamic acid
Kurumlar
Általános Orvostudományi Kar
Budapest Hungary
Azienda Socio Sanitaria Territoriale di Mantova
Mantova Italy
College of Life Sciences
Leicester United Kingdom
Copenhagen University Hospital
Copenhagen Denmark
Hospital Sultan Zainal Abidin
Kuala Nerus Malaysia
Hospital Universitario Virgen del Rocío
Sevilla Spain
Institute of Psychiatry and Neurology, Warszawa
Warsaw Poland
Keele University, School of Medicine
Keele United Kingdom
Nottingham Biomedical Research Centre
Nottingham United Kingdom
Nottingham University Hospitals NHS Trust
Nottingham United Kingdom
Royal Derby Hospital
Derby United Kingdom
Selçuk Tip Fakültesi
Konya Turkey
UCL Queen Square Institute of Neurology
London United Kingdom
Universitätsspital Basel
Basel Switzerland
Universiti Kebangsaan Malaysia
Bangi Malaysia
University of Nottingham
Nottingham United Kingdom
University of Nottingham Medical School
Nottingham United Kingdom