THE CORRELATION OF TRANEXAMIC ACID USED AS ANTIFIBRINOLYTIC THERAPY TO GLASGOW COMA SCALE FOR THE FIRST 7 DAYS IN HAEMORRHAGIC STROKE PATIENTS

Christianus Heru Setiawan; Zullies Ikawati; Abdul Gofir

doi:10.22159/ajpcr.2017.v10s2.19498

Authors

Christianus Heru Setiawan Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Sanata Dharma University, Indonesia
Zullies Ikawati Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Indonesia
Abdul Gofir Department of Neurology, Stroke Unit Dr. Sardjito Hospital, Indonesia

DOI:

https://doi.org/10.22159/ajpcr.2017.v10s2.19498

Keywords:

Hemorrhagic stroke, Tranexamic acid, Glasgow coma scale, Antifibrinolytic

Abstract

Objective: Treatment of haemorrhagic stroke using tranexamic acid is still used in some hospitals, to prevent the occurrence of the complication called rebleeding. Rebleeding is an important cause of bad outcomes that result loss of consciousness and even death. The administration of the antifibrinolytic tranexamic acid in patients with haemorrhagic stroke can reduce the occurrence of rebleeding but it also can increase poor outcome caused by cerebral ischemia that can worsen the patient's condition.

Methods: This study used observational study design, cohort, prospective, and multicenter. The purpose of this study was to determine the effectiveness of the use of tranexamic acid in patients with haemorrhagic stroke. Statistical testing is done by analyzing the Glasgow Coma Scale (GCS) score on day 1^st, day 3^rd, and day 7^th between the treatment groups haemorrhagic stroke patients who received tranexamic acid therapy as antifibrinolytic therapy in Bethesda Hospital for 23 patients compared with a control group of patients haemorrhagic stroke who did not receive therapy as tranexamic acid antifibrinolytic therapy in the Dr. Sardjito Hospital for 23 patients.

Results: The statistical analysis of the independent t-test showed that there was no significant difference between the average GCS score of day 1^st (P=262), day 3^rd (P=0.293), and day 7^th (P=0.648) between treatment group and control group. The statistical analysis of the Mann-Whitney showed that there was not significant difference comparing the difference between the pre and post GCS score at treatment group and control group (P=0.158).

Conclusion: Administration of tranexamic acid in patients with haemorrhagic stroke (treatment group) gives the same clinical response compared to the patients who did not receive tranexamic acid therapy (control group) based on assessment of the Glasgow Coma Scale (GCS) score.

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References

Goldstein L B, Adams R, Alberts M J, Appel L J, Brass L M, Bushnell C D. Primary prevention of ischemic stroke: a guideline. Am. Heart Assoc. 2006;37:1583-633.

Gofir A. Manajemen Stroke. Yogyakarta: Pustaka Cendekia Press; 2011.

Allen H. Tranexamic acid for bleeding | Medicine [Internet]. Egton Med. Inf. Syst. Ltd. 2012. [cited 2014] Available from: http://www.patient.co.uk/medicine/Tranexamic-acid.htm

Roos Y B, Rinkel G J E, Vermeulen M, Algra A, van Gijn J. Antifibrinolytic therapy for aneurysmal subarachnoid haemorrhage (Review). Cochrane Database Syst. Rev. 2008;CD001245.

Perhimpunan Dokter Spesialis Saraf Indonesia. Guideline Stroke. Jakarta: Perdossi; 2011.

Morgenstern L B, Hemphill III J C, Anderson C, Becker K, Broderick J P, Connolly E S. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline. Am. Heart Assoc. 2010;41:2108-2129.

Broderick J, Connolly S, Feldmann E, Hanley D, Kase C, Krieger D. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage in Adults: 2007 Update: A Guideline From the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Am. Heart Assoc. 2007;38:2001-23.

Sprigg N, Renton C J, Dineen R A, Kwong Y, Bath P M W. Tranexamic Acid for Spontaneous Intracerebral Hemorrhage: A Randomized Controlled Pilot Trial. J. Stroke Cerebrovasc. Dis. 2014;23:1312â€“8.

Roos Y. Antifibrinolytic Treatment in Aneurysmal Subarachnoid Haemorrhage: A randomized placebo-controlled trial. Neurology. 2000;54:77â€“82.

Tsementzis S A, Hitchcock E R, Meyer C H. Benefits and risks of antifibrinolytic therapy in the management of ruptured intracranial aneurysms. A double-blind placebo controlled study. Acta Neurochir. (Wien). 1990;102:1â€“10.

Vermeulen M, Lindsay K W, Murray G D. Antifibrinolytic treatment in subarachnoid hemorrhage. N. Engl. J. Med. 1984;311:432â€“7.

Wijdicks E F, Hasan D, Lindsay K W, Brouwers P J, Hatfield R, Murray G D. Short-term Tranexamic Acid Treatment in Aneurysmal Subarachnoid Hemorrhage. Am. Heart Assoc. 1989;20:1674-9.