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Effect of tranexamic acid in patients with colonic diverticular bleeding: A nationwide inpatient database study
Author(s) -
Miyamoto Yuki,
Ohbe Hiroyuki,
Ishimaru Miho,
Matsui Hiroki,
Fushimi Kiyohide,
Yasunaga Hideo
Publication year - 2021
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15247
Subject(s) - medicine , tranexamic acid , propensity score matching , odds ratio , confidence interval , lower gastrointestinal bleeding , blood transfusion , gastrointestinal bleeding , surgery , colonoscopy , blood loss , colorectal cancer , cancer
Background and Aim The effect of tranexamic acid (TXA) remains unknown in patients with colonic diverticular bleeding, which is one of the most common causes of lower gastrointestinal bleeding. We investigated the efficacy of TXA for patients with colonic diverticular bleeding. Methods We performed a nationwide observational study using the Japanese Diagnosis Procedure Combination database and identified patients who were admitted for diverticular bleeding from 2010 to 2018. Patients who received TXA on the day of admission comprised the TXA group, and the remaining patients comprised the control group. The primary outcome was in‐hospital mortality. Secondary outcomes included severe bleeding, blood transfusion within 7 days of admission, length of stay, and hospitalization costs. Propensity score matching was performed to compare outcomes between the two groups. Results Overall, 78 291 patients met our eligibility criteria, and 30 526 matched pairs were created by one‐to‐one propensity score matching. After matching, there was no significant difference in in‐hospital mortality between the two groups (odds ratio [OR], 1.07; 95% confidence interval [CI], 0.88–1.30); however, TXA administration was associated with significantly lower proportions of severe bleeding events (OR, 0.93; 95% CI, 0.89–0.99), blood transfusions (OR, 0.88; 95% CI, 0.84–0.92), shorter length of stay (difference, −0.23 days; 95% CI, −0.01 to −0.44 days), and lower total hospitalization costs (difference, −$233; 95% CI, −$153 to −$314). Conclusions Although TXA was not significantly associated with lower in‐hospital mortality, it may reduce severe bleeding, blood transfusions, length of stay, and hospitalization costs.