Tranexamic acid in non-traumatic intracranial bleeding: a systematic review and meta-analysis

Abstract Non-traumatic intracranial bleeding (NTIB), comprising subarachnoid hemorrhage (SAH) and intra-cranial bleeding (ICH) is a significant public health concern. Tranexamic acid (TXA) is a promising treatment with benefits yet to be fully demonstrated. We conducted a systematic review and meta-...

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Autores principales:	Jean-Baptiste Bouillon-Minois, Carolyne Croizier, Julien S. Baker, Bruno Pereira, Farès Moustafa, Justin Outrey, Jeannot Schmidt, Nicolas Peschanski, Frédéric Dutheil
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c5ff6c8755ff4994849ed86736813b95
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spelling	oai:doaj.org-article:c5ff6c8755ff4994849ed86736813b952021-12-02T18:46:55ZTranexamic acid in non-traumatic intracranial bleeding: a systematic review and meta-analysis10.1038/s41598-021-94727-y2045-2322https://doaj.org/article/c5ff6c8755ff4994849ed86736813b952021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-94727-yhttps://doaj.org/toc/2045-2322Abstract Non-traumatic intracranial bleeding (NTIB), comprising subarachnoid hemorrhage (SAH) and intra-cranial bleeding (ICH) is a significant public health concern. Tranexamic acid (TXA) is a promising treatment with benefits yet to be fully demonstrated. We conducted a systematic review and meta-analysis on the impact of TXA on mortality in NTIB. We searched the PubMed, Cochrane Library, Google Scholar and ScienceDirect databases for studies reporting mortality data following the use of TXA in NTIB for comparisons with a control group. We computed random-effect meta-analysis on estimates of risk and sensitivity analyses. We computed meta-regression to examine the putative effects of the severity of NTIB, sociodemographic data (age, sex), and publication date. Among potentially 10,008 articles, we included 15 studies representing a total of 4883 patients: 2455 receiving TXA and 2428 controls; 1110 died (23%) during the follow-up. The meta-analysis demonstrated a potential of 22% decrease in mortality for patients treated by TXA (RR = 0.78, 95%CI 0.58–0.98, p = 0.002). Meta-regression did not demonstrate any influence of the severity of NTIB, age, sex, length of treatment or date of publication. Sensitivity analyses confirmed benefits of TXA on mortality. TXA appears to be a therapeutic option to reduce non-traumatic intracranial bleeding mortality, particularly in patients with SAH.Jean-Baptiste Bouillon-MinoisCarolyne CroizierJulien S. BakerBruno PereiraFarès MoustafaJustin OutreyJeannot SchmidtNicolas PeschanskiFrédéric DutheilNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jean-Baptiste Bouillon-Minois Carolyne Croizier Julien S. Baker Bruno Pereira Farès Moustafa Justin Outrey Jeannot Schmidt Nicolas Peschanski Frédéric Dutheil Tranexamic acid in non-traumatic intracranial bleeding: a systematic review and meta-analysis
description	Abstract Non-traumatic intracranial bleeding (NTIB), comprising subarachnoid hemorrhage (SAH) and intra-cranial bleeding (ICH) is a significant public health concern. Tranexamic acid (TXA) is a promising treatment with benefits yet to be fully demonstrated. We conducted a systematic review and meta-analysis on the impact of TXA on mortality in NTIB. We searched the PubMed, Cochrane Library, Google Scholar and ScienceDirect databases for studies reporting mortality data following the use of TXA in NTIB for comparisons with a control group. We computed random-effect meta-analysis on estimates of risk and sensitivity analyses. We computed meta-regression to examine the putative effects of the severity of NTIB, sociodemographic data (age, sex), and publication date. Among potentially 10,008 articles, we included 15 studies representing a total of 4883 patients: 2455 receiving TXA and 2428 controls; 1110 died (23%) during the follow-up. The meta-analysis demonstrated a potential of 22% decrease in mortality for patients treated by TXA (RR = 0.78, 95%CI 0.58–0.98, p = 0.002). Meta-regression did not demonstrate any influence of the severity of NTIB, age, sex, length of treatment or date of publication. Sensitivity analyses confirmed benefits of TXA on mortality. TXA appears to be a therapeutic option to reduce non-traumatic intracranial bleeding mortality, particularly in patients with SAH.
format	article
author	Jean-Baptiste Bouillon-Minois Carolyne Croizier Julien S. Baker Bruno Pereira Farès Moustafa Justin Outrey Jeannot Schmidt Nicolas Peschanski Frédéric Dutheil
author_facet	Jean-Baptiste Bouillon-Minois Carolyne Croizier Julien S. Baker Bruno Pereira Farès Moustafa Justin Outrey Jeannot Schmidt Nicolas Peschanski Frédéric Dutheil
author_sort	Jean-Baptiste Bouillon-Minois
title	Tranexamic acid in non-traumatic intracranial bleeding: a systematic review and meta-analysis
title_short	Tranexamic acid in non-traumatic intracranial bleeding: a systematic review and meta-analysis
title_full	Tranexamic acid in non-traumatic intracranial bleeding: a systematic review and meta-analysis
title_fullStr	Tranexamic acid in non-traumatic intracranial bleeding: a systematic review and meta-analysis
title_full_unstemmed	Tranexamic acid in non-traumatic intracranial bleeding: a systematic review and meta-analysis
title_sort	tranexamic acid in non-traumatic intracranial bleeding: a systematic review and meta-analysis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/c5ff6c8755ff4994849ed86736813b95
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Tranexamic acid in non-traumatic intracranial bleeding: a systematic review and meta-analysis

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