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The use of Tranexamic Acid in Gastrointestinal (GI) bleeding

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The use of Tranexamic Acid in Gastrointestinal (GI) bleeding

Aims

The aims of this study are to assess current practice and determine the efficacy of Tranexamic Acid (TXA) in GI bleeding in our centre.

Method

A retrospective study, over a one year period, in a single DGH in Wales. Patients were identified through the hospital coding system. Notes and drug charts were reviewed. Inclusion criteria; any patient admitted under a general surgeon for GI bleeding as a primary complaint. Exclusion criteria; any patient admitted under another speciality or any patient admitted electively.

Results

There were 60 patients included in the study. 13 (22%) patients received TXA compared to 47 (78%) who did not. The mean length of stay for those who received TXA was 5.0 days compared to 1.9 days in the cohort who did not (P = 0.0028). The mean time to stop bleeding were 2.5 and 2.35 days respectively (P = 0.8853). 69% of those who received TXA required a blood transfusion compared to 17% without TXA.

Conclusion

The study group feel that the longer LOS/time to stop bleeding and the greater need for transfusion in those receiving TXA suggests that this cohort had the more severe bleeding rather than a direct consequence of the treatment. Although our figures suggest there is no statistical advantage of using TXA in GI bleeding, future work is required in the form of a RCT to establish it’s efficacy however given the evidence in a trauma setting we suggest it is advantageous. 

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