The effect of tranexamic acid in patients with TBI: a systematic review and meta-analysis of randomized controlled trials.

To conduct a systematic review and meta-analysis and evaluate the effect of tranexamic acid in patients with traumatic brain injury. PubMed, EMBASE, and CENTRAL (Cochrane Central Register of Controlled Trials) were searched to identify randomized controlled trials and evaluate the effect of tranexamic acid in traumatic brain injury patients. The primary outcome was mortality. Two reviewers extracted the data independently. The random effect meta-analysis was used to estimate the aggregate effect size of 95% confidence intervals. Six randomized controlled trials investigating tranexamic acid versus placebo and 30073 patients were included. Compared with placebo, tranexamic acid decreased the mortality (RR = 0.92; 95% CI, 0.87-0.96; p < 0.001) and growth of hemorrhagic mass (RR = 0.78; 95% CI, 0.61-0.99; p = 0.04). However, tranexamic acid could not decrease disability or independent, neurosurgery, vascular embolism, and stroke. Current evidence suggested that compared with placebo, tranexamic acid could reduce mortality and growth of hemorrhagic mass. This finding indicated that patients with traumatic brain injury should be treated with tranexamic acid.

A novel model for predicting the outcome of intracerebral hemorrhage: Based on 1186 Patients.

OBJECTIVE: To establish a model for predicting the outcome according to the clinical and computed tomography(CT) image data of patients with intracerebral hemorrhage(ICH). METHODS: The clinical and CT image data of the patients with ICH in Qinghai Provincial People's Hospital and Xuzhou Central Hospital were collected. The risk factors related to the poor outcome of the patients were determined by univariate and multivariate logistic regression analysis. To determine the effect of factors related to poor outcome, the nomogram model was made by software of R 3.5.2 and the support vector machine operation was completed by software of SPSS Modelor. RESULTS: A total of 8265 patients were collected and 1186 patients met the criteria of the study. Age, hospitalization days, blend sign, intraventricular extension, subarachnoid hemorrhage, midline shift, diabetes and baseline hematoma volume were independent predictors of poor outcome. Among these factors, baseline hematoma volume๥20ml (odds ratio:13.706, 95% confidence interval:9.070-20.709, p < 0.001) was the most significant factor for poor outcome, followed by the volume among 10ml-20ml (odds ratio:11.834, 95% confidence interval:7.909-17.707, p < 0.001). It was concluded that the highest percentage of weight in outcome was baseline hematoma volume (25.0%), followed by intraventricular hemorrhage (23.0%). CONCLUSION: This predictive model might accurately predict the outcome of patients with ICH. It might have a wide range of application prospects in clinical.

Establishment and Verification of the Hematoma Expansion Prediction Score of Intracerebral Hemorrhage in the Qinghai-Tibetan Plateau.

OBJECTIVE: The latest World Health Organization data showed that stroke was the highest mortality in China, accounting for 23.7% of the total mortality from 2000 to 2012. Intracerebral hemorrhage (ICH) was the most deadly and incurable type of stroke. In the Qinghai-Tibetan Plateau, the incidence of stroke was relatively higher. Several studies showed that the shape and heterogeneity of hematoma and image markers on brain computed tomography scan had predictive effects on hematoma expansion (HE). The study aimed to find relative factors and established a nomogram model to predict the HE of ICH. METHODS: All patients with ICH in Qinghai Provincial People's Hospital from January 1, 2012, to May 22, 2018, were continuously collected. A total of 402 patients were included in the study. This was a single-center retrospective study. Univariate and binary logistic regression analysis were performed to screen out the independent predictors that were significantly associated with HE. RESULTS: The total incidence of HE in ICH was 30.9%, whereas the incidence of HE in the basal ganglia and nonbasal ganglia was 36.4% and 17.2%, respectively. Diabetes, basal ganglia hemorrhage, time of onset to baseline computed tomography, island sign, blend sign, black hole sign, and swirl sign were independent predictors of HE. Based on these predictors, a nomogram model was established and the accuracy was 81.6%, the sensitivity was 91.1%, and the specificity was 70.5%. CONCLUSIONS: This model had a high accuracy of predicting HE in the Qinghai-Tibetan Plateau. Because this model is noninvasive, rapid, and low cost, it is easy to promote and has wide application prospects in clinical practice.