https://orcid.org/0000-0001-7669-6356
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Abstract
Aim: The efficacy of antifibrinolytics in subarachnoid hemorrhage remains unclear due to conflicting evidence from studies. Materials & methods: Online databases were queried to include randomized controlled trials and propensity matched observational studies. We used Review Manager for the statistical analysis, presenting results as odds ratios with 95% CI. Results: The 12 shortlisted studies included 3359 patients, of which 1550 (46%) were in the intervention (tranexamic acid) group and 1809 (54%) in the control group. Antifibrinolytic therapy significantly reduced the risk of rebleeding (OR: 0.55; 95% CI: 0.40–0.75; p = 0.0002) with no significant decrease in poor clinical outcome (OR: 1.02; 95% CI: 0.86–1.20; p = 0.85) and all-cause mortality (OR: 0.92; CI: 0.72–1.17; p = 0.50). Conclusion: In patients with subarachnoid hemorrhage, antifibrinolytics reduce the risk of rebleeding without significantly affecting mortality or clinical outcomes.
Supplementary data
To view the supplementary data that accompany this paper please visit the journal website at:www.tandfonline.com/doi/full/10.2217/epi-2016-0184
Author contributions
K Fatima's and M Aemaz Ur Rehman contributed equally to this article. M Aemaz Ur Rehman, K Fatima, A Asmar, H Farooq and N Ahmad contributed to the study design and conception, data extraction from the included studies, analysis, and manuscript writeup. A Danial, M Ebaad Ur Rehman, AA Khan, S Tahir, U Ahmed, A Khawaja and S Zubair contributed to the study design, literature search, data extraction, and manuscript writeup. All authors read and approved the final version of the manuscript.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
Ethical conduct of research
The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations.