Evidence map›Paper›PMID 33795489›Full record

SynthesisStroke and vascular neurology2021

Haemostatic therapy in spontaneous intracerebral haemorrhage patients with high-risk of haematoma expansion by CT marker: a systematic review and meta-analysis of randomised trials.

Ximing Nie, Jingyi Liu, Dacheng Liu, Qi Zhou, Wanying Duan, Yuehua Pu, Zhonghua Yang, Miao Wen, Haixin Sun, Wenzhi Wang and 3 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Stroke and vascular neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Frontoparietal intraparenchymal hemorrhage secondary to anticoagulation.International journal of emergency medicine · 2024
    Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Ximing NieDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.ORCID 0000-0002-8380-4076
Jingyi LiuDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.ORCID 0000-0001-7360-0267
Dacheng LiuDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.ORCID 0000-0003-3786-9255
Qi ZhouDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Wanying DuanDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.ORCID 0000-0003-3527-9454
Yuehua PuDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Zhonghua YangDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Miao WenDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Haixin SunBeijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Wenzhi WangBeijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Shengjun SunBeijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Hongqiu GuDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.ORCID 0000-0003-1608-1856
Liping LiuDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China lipingsister@gmail.com.ORCID 0000-0003-2943-055X
Capital Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeCurrent randomised controlled trials (RCTs) showed an uncertain benefit of haemostatic therapy on preventing haematoma expansion and improving the outcome in patients with intracerebral haemorrhage (ICH). This meta-analysis aims to systematically evaluate the effect of haemostatic agents on the prevention of haemorrhage growth in patients with high-risk spontaneous ICH predicted by CT signs in RCTs.

methodsA comprehensive search of PubMed, EMBASE and Cochrane library from 1 January 2005 to 30 June 2021 was conducted. RCTs that compared haemostatic agents with placebo for the treatment of spontaneous patients with ICH with high-risk haemorrhage growth were included. The primary endpoint was haematoma expansion at 24 hours. Other major endpoints of interest included 90-day functional outcome and mortality.

resultsThe meta-analysis included four RCTs that randomised 2666 patients with ICH with high-risk haemorrhage growth. Haemostatic therapy reduced the rate of haematoma expansion at a marginally statistically significant level when compared with placebo (OR 0.84; 95% CI 0.70 to 1.00; p=0.051). Subgroup analysis for patients with black hole sign on CT revealed a significant reduction of haematoma expansion with haemostatic therapy (OR 0.61; 95% CI 0.39 to 0.94; p=0.03). However, both the primary analysis and subgroup analyses showed that haemostatic therapy could not reduce the rate of poor functional outcome (modified Rankin Scale >3) or death.

conclusionsHaemostatic therapy showed a marginally significant benefit in reducing early haematoma expansion in patients with high-risk spontaneous ICH predicted by markers on CT scan. However, no significant improvement in functional outcome or reduction of mortality was observed.

Indexed as

HemostaticsCerebral HemorrhageHematomaHemostasisHumansRandomized Controlled Trials as TopicTomography, X-Ray ComputedHemostaticshaemorrhagestroke

Identifiers

PMID33795489
PMCPMC8258086
OpenAlexW3141637787

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.