Erratum to ‘Efficacy and safety of local fibrinolytic therapy in intracranial hemorrhages: A systematic review and meta-analysis of randomised controlled trials’ [World Neurosurgery: X (22C) (2024) 100316]
Background: Local fibrinolytic therapy for ICH and IVH are used to dissolve clots, but their role remains debatable. This review aims to study the efficacy and safety of local fibrinolytic therapy. Methods: Medline, Embase, CINAHL Plus, Cochrane, Scopus, Web of science, clinical trials.gov, WHO and...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | World Neurosurgery: X |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590139724001546 |
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| author | Arun Babu Rajeswaran Arshad Ali Saleh Safi Ahmed Eid Abdulghani Saleh |
| author_facet | Arun Babu Rajeswaran Arshad Ali Saleh Safi Ahmed Eid Abdulghani Saleh |
| author_sort | Arun Babu Rajeswaran |
| collection | DOAJ |
| description | Background: Local fibrinolytic therapy for ICH and IVH are used to dissolve clots, but their role remains debatable. This review aims to study the efficacy and safety of local fibrinolytic therapy. Methods: Medline, Embase, CINAHL Plus, Cochrane, Scopus, Web of science, clinical trials.gov, WHO and EU Clinical Trials Register were searched for RCTs only, on intra-clot fibrinolytics vs standard treatments for ICH and IVH. Results: Thirteen RCTs were included in the final data synthesis. In pooled analysis for IVH, fibrinolysis vs saline showed reduced mortality [RR-0.63 (0.46, 0.85)], less risk of ventriculitis [RR-0.59 (0.35, 1.00)] and higher daily reduction in clot size percentage [SMD-0.93 (0.39, 1.47)] with fibrinolysis but found no significant difference in functional outcome [RR-1.07 (0.88, 1.30)], in the risk of new bleedings [RR-1.36 (0.44, 4.23)] and shunt-dependent hydrocephalus (RR-1.10 [0.77, 1.59)]. In pooled analysis for ICH, with fibrinolysis vs standard craniotomy, there was a reduced mortality [RR-0.65 (0.20, 2.51)] with decreased risk for new hemorrhages in the fibrinolysis arm [RR-0.48 (0.30, 0.78)] while in fibrinolysis vs standard medical treatment, the trend was also a reduced mortality [RR-0.83 (0.65, 1.05)] with favourable outcome [RR-1.20 (1.00, 1.44)] and higher risk of new bleeds (RR-2.27 [1.23, 4.19]) but no significant difference in brain infections (RR-1.34 [0.24, 7.49]). Conclusion: Local fibrinolytic therapy in ICH and IVH decreases mortality and improves the clot resolution but shows no substantial gain in the good functional outcome and has increased risk of new hemorrhages. Further studies required to consolidate evidence for their efficacy and safety. |
| format | Article |
| id | doaj-art-15bf6e45b46f467183bea2acb8571752 |
| institution | Kabale University |
| issn | 2590-1397 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Neurosurgery: X |
| spelling | doaj-art-15bf6e45b46f467183bea2acb85717522025-02-10T04:34:52ZengElsevierWorld Neurosurgery: X2590-13972025-01-0125100423Erratum to ‘Efficacy and safety of local fibrinolytic therapy in intracranial hemorrhages: A systematic review and meta-analysis of randomised controlled trials’ [World Neurosurgery: X (22C) (2024) 100316]Arun Babu Rajeswaran0Arshad Ali1Saleh Safi2Ahmed Eid Abdulghani Saleh3Department of Neurosurgery, Sheikh Khalifa Medical City, Abu Dhabi, United Arab EmiratesDepartment of Neurosurgery, Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar; Department of Clinical Academic Sciences, College of Medicine, Qatar University, Doha, Qatar; Department of Neurological Sciences, Weill Cornell Medicine, Doha, Qatar; Corresponding author. Department of Clinical Academic Sciences, College of Medicine, Qatar University, Doha, Qatar.Department of Neurosurgery, Neuroscience Institute, Hamad Medical Corporation, Doha, QatarDepartment of Neurosurgery, Neuroscience Institute, Hamad Medical Corporation, Doha, QatarBackground: Local fibrinolytic therapy for ICH and IVH are used to dissolve clots, but their role remains debatable. This review aims to study the efficacy and safety of local fibrinolytic therapy. Methods: Medline, Embase, CINAHL Plus, Cochrane, Scopus, Web of science, clinical trials.gov, WHO and EU Clinical Trials Register were searched for RCTs only, on intra-clot fibrinolytics vs standard treatments for ICH and IVH. Results: Thirteen RCTs were included in the final data synthesis. In pooled analysis for IVH, fibrinolysis vs saline showed reduced mortality [RR-0.63 (0.46, 0.85)], less risk of ventriculitis [RR-0.59 (0.35, 1.00)] and higher daily reduction in clot size percentage [SMD-0.93 (0.39, 1.47)] with fibrinolysis but found no significant difference in functional outcome [RR-1.07 (0.88, 1.30)], in the risk of new bleedings [RR-1.36 (0.44, 4.23)] and shunt-dependent hydrocephalus (RR-1.10 [0.77, 1.59)]. In pooled analysis for ICH, with fibrinolysis vs standard craniotomy, there was a reduced mortality [RR-0.65 (0.20, 2.51)] with decreased risk for new hemorrhages in the fibrinolysis arm [RR-0.48 (0.30, 0.78)] while in fibrinolysis vs standard medical treatment, the trend was also a reduced mortality [RR-0.83 (0.65, 1.05)] with favourable outcome [RR-1.20 (1.00, 1.44)] and higher risk of new bleeds (RR-2.27 [1.23, 4.19]) but no significant difference in brain infections (RR-1.34 [0.24, 7.49]). Conclusion: Local fibrinolytic therapy in ICH and IVH decreases mortality and improves the clot resolution but shows no substantial gain in the good functional outcome and has increased risk of new hemorrhages. Further studies required to consolidate evidence for their efficacy and safety.http://www.sciencedirect.com/science/article/pii/S2590139724001546 |
| spellingShingle | Arun Babu Rajeswaran Arshad Ali Saleh Safi Ahmed Eid Abdulghani Saleh Erratum to ‘Efficacy and safety of local fibrinolytic therapy in intracranial hemorrhages: A systematic review and meta-analysis of randomised controlled trials’ [World Neurosurgery: X (22C) (2024) 100316] World Neurosurgery: X |
| title | Erratum to ‘Efficacy and safety of local fibrinolytic therapy in intracranial hemorrhages: A systematic review and meta-analysis of randomised controlled trials’ [World Neurosurgery: X (22C) (2024) 100316] |
| title_full | Erratum to ‘Efficacy and safety of local fibrinolytic therapy in intracranial hemorrhages: A systematic review and meta-analysis of randomised controlled trials’ [World Neurosurgery: X (22C) (2024) 100316] |
| title_fullStr | Erratum to ‘Efficacy and safety of local fibrinolytic therapy in intracranial hemorrhages: A systematic review and meta-analysis of randomised controlled trials’ [World Neurosurgery: X (22C) (2024) 100316] |
| title_full_unstemmed | Erratum to ‘Efficacy and safety of local fibrinolytic therapy in intracranial hemorrhages: A systematic review and meta-analysis of randomised controlled trials’ [World Neurosurgery: X (22C) (2024) 100316] |
| title_short | Erratum to ‘Efficacy and safety of local fibrinolytic therapy in intracranial hemorrhages: A systematic review and meta-analysis of randomised controlled trials’ [World Neurosurgery: X (22C) (2024) 100316] |
| title_sort | erratum to efficacy and safety of local fibrinolytic therapy in intracranial hemorrhages a systematic review and meta analysis of randomised controlled trials world neurosurgery x 22c 2024 100316 |
| url | http://www.sciencedirect.com/science/article/pii/S2590139724001546 |
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