Evidence map›Paper›PMID 41777112›Full record

SynthesisAnnals of medicine2026

Tranexamic acid in spontaneous intracerebral hemorrhage: an updated systematic review and meta-analysis of randomized controlled trials.

Cuilin Que, Luda Feng, Xinxing Lai, Yonghong Gao, Hongrui Zhang, Chenxi Tao, Lingbo Kong, Zhenhong Liu, Ying Gao

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Annals of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

Cuilin QueDepartment of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.ORCID 0009-0003-3255-5959
Luda FengDongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.ORCID 0000-0002-7259-4421
Xinxing LaiDepartment of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Yonghong GaoKey Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Hongrui ZhangDepartment of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Chenxi TaoKey Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Lingbo KongDepartment of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.ORCID 0000-0001-5451-4355
Zhenhong LiuDepartment of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.ORCID 0000-0002-9563-6487
Ying GaoDepartment of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.ORCID 0000-0001-6972-3846

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTranexamic acid (TXA) is a well-established antifibrinolytic medication in the general population. However, its efficacy and safety for patients with spontaneous intracerebral hemorrhage (ICH) remain inconclusive. Consequently, we conducted a systematic review and meta-analysis to assess the effectiveness and safety of TXA for spontaneous ICH.

methodsWe conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) following established methodological standards. Our search encompassed eight electronic databases from inception to April 25, 2024. The primary outcome was a reduction in all-cause mortality. The secondary outcomes included improvements in functional independence, neurological impairment, activities of daily living, and reduction in hematoma expansion (HE). Fixed-effects or random-effects model were performed for pooled data where eligible.

resultsA total of 9 RCTs that initially enrolled 3,124 patients were included. There were no significant differences observed concerning all-cause mortality (RR, 1.03; 95% CI [0.89-1.18]), hematoma expansion (RR, 0.90; 95% CI [0.80-1.00]), improvement of functional independence (RR, 1.02; 95% CI [0.92-1.12], neurological impairment (MD, -0.88 [95% CI, -2.22-0.45]), or activities in daily living (MD, -0.83 [95% CI, -29.25-12.59]). The pooled data indicated that TXA for ICH was associated with a decrease in hematoma volume from baseline (MD, -1.74; 95% CI [-2.47 to -1.02]). No significant difference in adverse events was observed between the TXA group and the control group.

conclusionsIn summary, TXA does not affect all-cause mortality, functional outcomes, or neurological impairment, nor does it reduce HE, despite reducing hematoma volulume. TXA use for ICH requires careful clinical consideration.

Indexed as

Antifibrinolytic AgentsCerebral HemorrhageTranexamic AcidActivities of Daily LivingHematomaHumansRandomized Controlled Trials as TopicTreatment OutcomeAntifibrinolytic AgentsTranexamic AcidHematoma expansionintracerebral hemorrhagesystematic reviewtranexamic acid

Identifiers

PMID41777112
PMCPMC12961703

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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.