• Media type: E-Article
  • Title: Association of Intraventricular Fibrinolysis With Clinical Outcomes in Intracerebral Hemorrhage: An Individual Participant Data Meta-Analysis
  • Contributor: Kuramatsu, Joji B. [Author]; Gerner, Stefan T. [Author]; Falcone, Guido J. [Author]; Selim, Magdy H. [Author]; Lioutas, Vasileios-Arsenios [Author]; Endres, Matthias [Author]; Zweynert, Sarah [Author]; Vajkoczy, Peter [Author]; Ringleb, Peter A. [Author]; Purrucker, Jan C. [Author]; Volkmann, Jens [Author]; Neugebauer, Hermann [Author]; Ziai, Wendy [Author]; Erbguth, Frank [Author]; Schellinger, Peter D. [Author]; Knappe, Ulrich J. [Author]; Fink, Gereon Rudolf [Author]; Dohmen, Christian [Author]; Minnerup, Jens [Author]; Reichmann, Heinz [Author]; Schneider, Hauke [Author]; Röther, Joachim [Author]; Reimann, Gernot [Author]; Bardutzky, Jürgen [Author]; [...]
  • Published: Lippincott Williams & Wilkins, 2022
  • Published in: Stroke 53(9), 2876 - 2886 (2022). doi:10.1161/STROKEAHA.121.038455
  • Language: English
  • DOI: https://doi.org/10.1161/STROKEAHA.121.038455
  • ISSN: 0039-2499; 1524-4628
  • Origination:
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  • Description: Background:In patients with intracerebral hemorrhage (ICH), the presence of intraventricular hemorrhage constitutes a promising therapeutic target. Intraventricular fibrinolysis (IVF) reduces mortality, yet impact on functional disability remains unclear. Thus, we aimed to determine the influence of IVF on functional outcomes.Methods:This individual participant data meta-analysis pooled 1501 patients from 2 randomized trials and 7 observational studies enrolled during 2004 to 2015. We compared IVF versus standard of care (including placebo) in patients treated with external ventricular drainage due to acute hydrocephalus caused by ICH with intraventricular hemorrhage. The primary outcome was functional disability evaluated by the modified Rankin Scale (mRS; range: 0–6, lower scores indicating less disability) at 6 months, dichotomized into mRS score: 0 to 3 versus mRS: 4 to 6. Secondary outcomes included ordinal-shift analysis, all-cause mortality, and intracranial adverse events. Confounding and bias were adjusted by random effects and doubly robust models to calculate odds ratios and absolute treatment effects (ATE).
  • Access State: Open Access