A Cochrane review [Abstract] 1 included 12 RCTs involving 1732 patients. There were 7 RCTs of blood clotting factors vs. placebo or open control (n=1480), 3 RCTs of antifibrinolytic drugs vs. placebo or open control (n=57), one RCT of platelet transfusion vs. open control (n=190), and one RCT of blood clotting factors vs. fresh frozen plasma (n=5). In the RCT of platelet transfusion vs. open control for acute spontaneous ICH associated with antiplatelet drug use, there was a significant increase in death or dependence at day 90 (70/97 versus 52/93; RR 1.29, 95% CI 1.04 to 1.61; n=190). All findings were non-significant for blood clotting factors vs. placebo or open control for acute spontaneous ICH with or without surgery, for antifibrinolytic drugs vs. placebo or open control for acute spontaneous ICH, and for clotting factors vs. fresh frozen plasma for acute spontaneous ICH associated with anticoagulant drug use.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment).
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