INTRODUCTION The practice of platelet transfusion to mitigate the deleterious effects of antiplatelet agents on spontaneous intracerebral hemorrhage (ICH) remains common. However, the effect of antiplatelet agents on patients with ICH is still controversial and transfusing platelets is not without risk. We performed a meta-analysis in order to determine the effect of platelet transfusion on antiplatelet agent associated ICH. METHODS We queried PubMed, Embase, and Scopus databases to identify cohort studies, case-control studies, and randomized control trials. Study quality was graded by the Newcastle-Ottawa Scale and Cochrane Risk of Bias tool, as appropriate. Outcomes of interest included functional independence as measured by the modified Rankin Scale and mortality. We compared patients with antiplatelet agent associated ICH who received platelet transfusion to those that did not. RESULTS We identified 625 articles. After reviewing 44 full text articles, 5 were deemed appropriate for meta-analysis, including 4 cohort studies and one randomized control trial. Considerable heterogeneity was present among the studies (I2 > 81% for all analyses). We did not find a significant effect of platelet transfusions on functional independence (Odds Ratio [OR] 1.3, 95% CI.0.45-3.9) or mortality (OR 0.58, 95% Confidence Interval [CI] 0.12-2.6). CONCLUSION We found no evidence for an effect of platelet transfusions on functional independence or mortality following antiplatelet associated ICH. More randomized trials are needed to evaluate platelet transfusion in patients with ICH and proven reduced platelet activity or those requiring neurosurgical intervention.

中文翻译：

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血小板输注对抗血小板治疗相关自发性脑出血后功能独立性和死亡率的影响：系统评价和荟萃分析

引言 输注血小板以减轻抗血小板药物对自发性脑出血 (ICH) 的有害影响的做法仍然很常见。然而，抗血小板药物对 ICH 患者的影响仍存在争议，输注血小板并非没有风险。我们进行了一项荟萃分析，以确定血小板输注对抗血小板药物相关 ICH 的影响。方法 我们查询了 PubMed、Embase 和 Scopus 数据库，以确定队列研究、病例对照研究和随机对照试验。研究质量由纽卡斯尔-渥太华量表和 Cochrane 偏倚风险工具酌情分级。感兴趣的结果包括功能独立性，由改良的 Rankin 量表和死亡率衡量。我们将接受血小板输注的抗血小板药物相关 ICH 患者与未输注的患者进行了比较。结果 我们确定了 625 篇文章。在审查了 44 篇全文文章后，有 5 篇被认为适合进行荟萃分析，其中包括 4 项队列研究和一项随机对照试验。研究之间存在相当大的异质性（所有分析的 I2 > 81%）。我们没有发现血小板输注对功能独立性（优势比 [OR] 1.3，95% CI.0.45-3.9）或死亡率（OR 0.58，95% 置信区间 [CI] 0.12-2.6）有显着影响。结论 我们没有发现血小板输注对抗血小板相关 ICH 后功能独立性或死亡率的影响的证据。