Treatment of intraventricular hemorrhage with urokinase: Effects on 30- day survival

Neal J. Naff, Juan R. Carhuapoma, Michael A. Williams, Anish Bhardwaj, John A. Ulatowski, Joshua Bederson, Ross Bullock, Erich Schmutzhard, Bettina Pfausler, Penelope M. Keyl, Stanley Tuhrim, Daniel F. Hanley

Research output: Contribution to journalArticle

153 Citations (Scopus)

Abstract

Background and Purpose - Intraventricular hemorrhage (IVH) remains associated with high morbidity and mortality. Therapy with external ventricular drainage alone has not modified outcome in these patients. Methods - Twelve pilot IVH patients who required external ventricular drainage were prospectively treated with intraventricular urokinase followed by the randomized, double-blinded allocation of 8 patients to either treatment or placebo. Observed 30-day mortality was compared with predicted 30-day mortality obtained by use of a previously validated method. Results - Twenty patients were enrolled; admission Glasgow Coma Scale score in 11 patients was ≤8; 10 patients had pulse pressure <85 mm Hg. Mean±SD ICH volume in 16 patients was 6.21±7.53 cm3 (range 0 to 23.88 cm3), and mean±SD intraventricular hematoma volume was 44.26±31.65 cm3 (range 1.31 to 100.36 cm3). Four patients (20%) died within 30 days. Predicted mortality for these 20 patients was 68.42% (range 3% to 100%). Probability of observing ≤4 deaths among 20 patients under a 68.42% expected mortality is 0.000012. Conclusions - Intraventricular urokinase may significantly improve 30-day survival in IVH patients. On the basis of current evidence, a double-blinded, placebo-controlled, multicenter study that uses thrombolysis to treat IVH has received funding and began January 1, 2000.

Original languageEnglish (US)
Pages (from-to)841-847
Number of pages7
JournalStroke
Volume31
Issue number4
StatePublished - Apr 2000
Externally publishedYes

Fingerprint

Urokinase-Type Plasminogen Activator
Hemorrhage
Survival
Mortality
Therapeutics
Drainage
Placebos
Glasgow Coma Scale
Hematoma
Multicenter Studies
Blood Pressure
Morbidity

Keywords

  • Intraventricular hemorrhage
  • Outcome
  • Urokinase

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Naff, N. J., Carhuapoma, J. R., Williams, M. A., Bhardwaj, A., Ulatowski, J. A., Bederson, J., ... Hanley, D. F. (2000). Treatment of intraventricular hemorrhage with urokinase: Effects on 30- day survival. Stroke, 31(4), 841-847.

Treatment of intraventricular hemorrhage with urokinase : Effects on 30- day survival. / Naff, Neal J.; Carhuapoma, Juan R.; Williams, Michael A.; Bhardwaj, Anish; Ulatowski, John A.; Bederson, Joshua; Bullock, Ross; Schmutzhard, Erich; Pfausler, Bettina; Keyl, Penelope M.; Tuhrim, Stanley; Hanley, Daniel F.

In: Stroke, Vol. 31, No. 4, 04.2000, p. 841-847.

Research output: Contribution to journalArticle

Naff, NJ, Carhuapoma, JR, Williams, MA, Bhardwaj, A, Ulatowski, JA, Bederson, J, Bullock, R, Schmutzhard, E, Pfausler, B, Keyl, PM, Tuhrim, S & Hanley, DF 2000, 'Treatment of intraventricular hemorrhage with urokinase: Effects on 30- day survival', Stroke, vol. 31, no. 4, pp. 841-847.
Naff NJ, Carhuapoma JR, Williams MA, Bhardwaj A, Ulatowski JA, Bederson J et al. Treatment of intraventricular hemorrhage with urokinase: Effects on 30- day survival. Stroke. 2000 Apr;31(4):841-847.
Naff, Neal J. ; Carhuapoma, Juan R. ; Williams, Michael A. ; Bhardwaj, Anish ; Ulatowski, John A. ; Bederson, Joshua ; Bullock, Ross ; Schmutzhard, Erich ; Pfausler, Bettina ; Keyl, Penelope M. ; Tuhrim, Stanley ; Hanley, Daniel F. / Treatment of intraventricular hemorrhage with urokinase : Effects on 30- day survival. In: Stroke. 2000 ; Vol. 31, No. 4. pp. 841-847.
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