Early Tranexamic Acid Therapy and Its Influence on Hemoglobin Dynamics, Hospital Stay, and ICU Admissions in Upper Gastrointestinal Bleeding.

Cureus · 2026 · Benefit · Low evidence

BenefitLow evidencePaper 11

In this prospective observational study (n=220), early intravenous tranexamic acid (within 6 hours) was associated with higher hemoglobin at 24 hours, 48 hours, and discharge versus standard care, fewer transfused units, shorter hospital stay, and lower ICU a…

Study snapshot

PublicationCureus · 2026

Study typeother

Reported directionBenefit

Evidence ratingLow

Abstract

Background Upper gastrointestinal bleeding (UGIB) is a life-threatening emergency associated with substantial morbidity, frequent transfusion needs, and prolonged hospitalization. Tranexamic acid (TXA) may reduce bleeding by stabilizing fibrin clots, but evidence regarding its early use in UGIB remains mixed. Objective This study evaluated whether early TXA administration influences hemoglobin dynamics, hospital stay, and ICU admissions in patients presenting with UGIB. Methods This prospective observational study was conducted at Shifa International Hospital, Islamabad, Pakistan, over 24 months. A total of 220 adult patients with UGIB were enrolled through purposive sampling and divided into two equal groups: an early TXA group receiving intravenous TXA within six hours of presentation (n=110) and a control group receiving standard care (n=110). Baseline demographic and clinical characteristics were similar between groups. Primary outcomes included hemoglobin levels at baseline, 24 hours, 48 hours, and discharge. Secondary outcomes included hospital length of stay, ICU admissions, blood transfusion requirements, and in-hospital mortality. Multivariable regression analyses were performed to adjust for age, comorbidities, baseline hemoglobin, bleeding source, and endoscopic interventions. Results Early TXA significantly preserved hemoglobin at 24 hours (9.2 ± 1.4 vs. 8.5 ± 1.6 g/dL, p < 0.001), 48 hours (8.9 ± 1.3 vs. 8.1 ± 1.5 g/dL, p < 0.001), and discharge (9.0 ± 1.2 vs. 8.2 ± 1.4 g/dL, p < 0.001). Hospital stay was shorter with TXA (5 (4-7) vs. 7 (5-9) days, p < 0.001), and ICU admissions were lower (10.9% vs. 23.6%, p = 0.008). TXA-treated patients required fewer transfusions (1.2 ± 0.8 vs. 2.0 ± 1.1 units, p < 0.001). Mortality was lower but not statistically significant (3.6% vs. 7.3%, p = 0.25). Multivariable analysis confirmed independent associations between early TXA and reduced hemoglobin drop, shorter hospital stay, and lower ICU admission odds. Conclusion Early TXA administration improves hemoglobin preservation, reduces transfusion needs, shortens hospitalization, and lowers ICU admissions in UGIB, supporting its role as an effective early adjunct in acute management.

Machine Enhanced Logic

AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typeother

Effect directionbenefit

PopulationAdult patients presenting with upper gastrointestinal bleeding (UGIB) at Shifa International Hospital, Islamabad, Pakistan

Sample size220

ExposureNot supplied

Evidence strengthLowConfidence: 74% · Peer reviewed: yes

Main findings

Outcomes measured

Hemoglobin levels (baseline, 24 hours, 48 hours, discharge)
Hospital length of stay
ICU admissions
Blood transfusion requirements
In-hospital mortality

Limitations

Prospective observational (non-randomized) design
Purposive sampling

View raw extracted JSON

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  },
  "population": "Adult patients presenting with upper gastrointestinal bleeding (UGIB) at Shifa International Hospital, Islamabad, Pakistan",
  "sample_size": 220,
  "outcomes": [
    "Hemoglobin levels (baseline, 24 hours, 48 hours, discharge)",
    "Hospital length of stay",
    "ICU admissions",
    "Blood transfusion requirements",
    "In-hospital mortality"
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  "main_findings": "In this prospective observational study (n=220), early intravenous tranexamic acid (within 6 hours) was associated with higher hemoglobin at 24 hours, 48 hours, and discharge versus standard care, fewer transfused units, shorter hospital stay, and lower ICU admission rates. In-hospital mortality was lower in the TXA group but not statistically significant.",
  "effect_direction": "benefit",
  "limitations": [
    "Prospective observational (non-randomized) design",
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  "evidence_strength": "low",
  "confidence": 0.74,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "upper gastrointestinal bleeding",
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    "hemoglobin",
    "hospital length of stay",
    "ICU admission",
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  "suggested_hubs": []
}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.7759/cureus.100738
PubMed: 41640907

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