PDF(Pubmed)
Abstract：
Background: The mortality rate associated with nontraumatic intracranial hemorrhage (NTICrH) remains consistently high under the current care modality. The effectiveness of tranexamic acid (TXA) as a treatment option is still a subject of debate. This study aims to assess the association between TXA administration and both short-term and long-term mortality rates in patients with NTICrH. Methods: We conducted a retrospective cohort study using data from the Taiwan National Health Insurance Research Database (NHIRD) spanning from January 2000 to December 2017. The study population consists of NTICrH patients admitted to the ICU, divided into two groups: patients who were treated with TXA and those who were not. Propensity score matching (PSM) was conducted to balance the baseline characteristics of the two groups. Cox proportional hazard analysis was conducted to estimate the hazard ratio (HR) for the all-cause mortality. Sensitivity analyses were performed using the inverse probability of treatment-weighted hazard ratio (IPTW-HR). To assess the timing of TXA use, we compared the risk of all-cause mortality within 180 days between patients receiving early TXA treatment and those receiving late TXA treatment. Results: There was no significant difference in 180-day all-cause mortality between the groups; the hazard ratio was 1.07 (95% CI: 0.96-1.20) in patients treated with TXA compared to those without TXA treatment. Within 7 days of admission, patients treated with TXA had a lower hazard ratio of 0.81 (95% CI: 0.74-0.90) for all-cause mortality. Conclusions: Lower mortality within the first 7 days was observed in patients with NTICrH who received TXA.
摘要：
背景：在当前的护理模式下，与非创伤性颅内出血（NTICrH）相关的死亡率一直很高。氨甲环酸（TXA）作为治疗选择的有效性仍然是一个争论的话题。这项研究旨在评估NTICrH患者TXA给药与短期和长期死亡率之间的关系。方法：我们使用2000年1月至2017年12月台湾国民健康保险研究数据库（NHIRD）的数据进行了一项回顾性队列研究。研究人群包括入住ICU的NTICrH患者，分为两组：接受TXA治疗的患者和未接受TXA治疗的患者。进行倾向评分匹配(PSM)以平衡两组的基线特征。进行Cox比例风险分析以估计全因死亡率的风险比（HR）。使用治疗加权风险比（IPTW-HR）的逆概率进行敏感性分析。为了评估TXA使用的时机，我们比较了接受早期TXA治疗和接受晚期TXA治疗的患者180天内全因死亡的风险.结果：两组之间180天全因死亡率没有显着差异；与未接受TXA治疗的患者相比，接受TXA治疗的患者的风险比为1.07（95％CI：0.96-1.20）。入院后7天内,TXA治疗的患者全因死亡率的风险比较低,为0.81(95%CI:0.74~0.90).结论：在接受TXA的NTICrH患者中，前7天内死亡率较低。
