ABSTRACT NUMBER: ESOC2026A892 IMPACT OF THROMBOLYTIC AGENTS ON MORTALITY AND MORBIDITY IN PATIENTS WITH INTRAVENTRICULAR HEMORRHAGE; A META-ANALYSIS OF 1397 PATIENTS

Abstract Background and aims Intraventricular hemorrhage (IVH) is a significant cause of mortality and morbidity worldwide. Intraventricular fibrinolytic therapy (IVF), administered through a catheter or an external ventricular device (EVD), is increasingly being adopted as a treatment strategy. To evaluate the efficacy of IVF; either intraventricular administration of tissue plasminogen activator (tPA) or urokinase (UK) in patients with IVH. Methods Scopus, Cochrane, WOS, and PubMed were searched for relevant studies from inception to December 2024. IVF with saline or placebo injection for IVH. RevMan software presented three outcomes as ORs with CIs under a RE model. Subgroup analysis by fibrinolytic agent was also done. Results Our analysis included 21 clinical studies comprising 1,397 patients. Our findings indicate that IVF significantly reduced mortality in IVH patients compared to placebo [OR 0.40, 95% CI (0.25 to 0.63); P < 0.0001]. However, no significant difference was observed between the two groups regarding brain infections [P = 0.63] or shunt dependency [P = 0.64]. Subgroup analysis revealed that both tPA and UK significantly reduced the odds of mortality in IVH patients compared to controls [tPA: P = 0.003; UK: P = 0.0003]. However, neither tPA nor UK demonstrated a statistically significant effect on brain infections or shunt dependency compared to the control group. Conclusions Our pooled research reveals that IVH patients may benefit from IVF by lowering mortality. There were no significant differences in brain infections or shunt reliance between IVF and control groups. More study is needed to determine how IVF affects secondary outcomes in this population. Conflict of interest nada ahmed. nothing to disclose, Wesal Mahmoud. nothing to disclose, Alyaa Madeeh. nothing to disclose