Review Article

Is There a Role for Tranexamic Acid in Upper GI Bleeding? A Systematic Review and Meta-Analysis

Table 2

Summary of studies included in systematic review.

Study IDCharacteristics

HALT-IT 2020Methods:
Randomised controlled trial
Participants:
12009 patients randomly assigned
Inclusion criteria:
GI bleed (upper or lower, however 89% were classified as upper GI bleeds)
Mean age TXA group: 58
Mean age placebo group: 58
7743 males
4266 females
Interventions:
TXA 1 g IV stat then 3 g infused over 24 hours
Outcomes:
Mortality:
TXA group 222/5994
Placebo group 226/6015
Rebleeding:
Not reported
Adverse events MI, CVA, PE:
TXA group 42/5994
Placebo group 46/6015
Need for surgery:
TXA group 146/5994
Placebo group 158/6015
Transfusion required:
TXA group 4076/5994
Placebo group 4129/6015
Bagnenko 2011Methods:
Randomised controlled trial
Participants:
47 patients randomly assigned
Inclusion criteria:
Suspected upper GI bleed
Mean age TXA group: 62
Mean age placebo group: 64
29 males
18 females
Interventions:
TXA 10 mg IV/PO TDS for 3 days versus placebo
Outcomes:
Mortality:
TXA group 1/22
Placebo group 3/25
Rebleeding:
TXA group 2/22
Placebo group: 5/25
Adverse events:
Not reported
Need for surgery:
TXA 1/22
Placebo 3/25
Transfusion required:
TXA 14/22
Placebo 13/25
Hawkey 2001Methods:
Randomised controlled trial
Participants:
206 patients randomly assigned.
Inclusion criteria:
Suspected upper GI bleed
Mean age TXA group: 58
Mean age placebo group: 58
126 males
80 females
Interventions:
TXA 2 g PO bolus then 1 g QDS for 4 days
Outcomes:
Mortality:
TXA group 4/103
Placebo group 5/103
Rebleeding:
TXA group 9/103
Placebo group: 10/103
Adverse events:
No breakdown between intervention and control
Need for surgery:
TXA 5/103
Placebo 6/103
Transfusion required:
TXA 58/103
Placebo 60/103
Holstein 1987Methods:
Randomised controlled trial
Participants:
128 patients randomly assigned
Inclusion criteria:
Suspected upper GI bleed
Mean age TXA group: 62
Mean age placebo group: 65
90 males
38 females
Interventions:
TXA 1 g every 4 hours for 24 hours then 1.5 g PO QDS for 5 days
Outcomes:
Mortality:
TXA group 2/128
Placebo group 4/128
Rebleeding:
TXA group 10/128
Placebo group 19/128
Adverse events MI, CVA, PE:
TXA group 0/128
Placebo group 2/128
Need for surgery:
TXA group 3/128
Placebo group 15/128
Transfusion required:
TXA group 47/128
Placebo group 54/128
Bergqvist 1980Methods:
Randomised controlled trial
Participants:
50 patients randomly assigned
Inclusion criteria:
Suspected upper GI bleed
Mean age TXA group: 61
Mean age placebo group: 58
40 males
10 females
Interventions:
TXA 2 g PO 4 hourly for two days
Outcomes:
Mortality:
TXA group 3/25
Placebo group 5/25
Rebleeding:
Not reported
Adverse events MI, CVA, PE:
Not reported
Need for surgery:
TXA group 7/25
Placebo group 7/25
Transfusion required:
Not reported

Engquist 1979Methods:
Randomised controlled trial
Participants:
204 patients randomly assigned
Inclusion criteria:
Suspected upper GI bleed
Mean age TXA group: 59
Mean age placebo group: 56
159 males
45 females
Interventions:
TXA 1 g IV 4 hourly for 1 day then 1.5 g PO QDS for 6 days
Outcomes:
Mortality:
TXA group 11/102
Placebo group 12/102
Rebleeding:
TXA group 23/102
Placebo group 29/102
Adverse events MI, CVA, PE:
TXA group 4/102
Placebo group 2/102
Need for surgery:
TXA group 10/102
Placebo group 18/102
Transfusion required:
Not reported
Biggs 1976Methods:
Randomised controlled trial
Participants:
200 patients randomly assigned
Inclusion criteria:
Suspected upper GI bleed
Mean age TXA group: not reported
Mean age placebo group: not reported
156 males
44 females
Interventions:
TXA 1 g IV stat then 1 g PO QDS on day 1,
Then 1 g QDS for 4 days
Outcomes:
Mortality:
TXA group 2/103
Placebo group 4/97
Rebleeding:
TXA group 7/103
Placebo group 21/97
Adverse events MI, CVA, PE:
Not reported
Need for surgery:
TXA group 7/103
Placebo group 21/97
Transfusion required:
TXA group 77/103
Placebo group 71/97

Cormack 1973Methods:
Randomised controlled trial
Participants:
150 patients randomly assigned
Inclusion criteria:
Suspected upper GI bleed
Mean age TXA group: not reported
Mean age placebo group: not reported
101 males
49 females
Interventions:
TXA 1.5 g QDS for 7 days
Outcomes:
Mortality:
TXA group 3/76
Placebo group 3/74
Rebleeding:
TXA group 8/76
Placebo group 11/74
Adverse events MI, CVA, PE:
Not reported
Need for surgery:
Not reported
Transfusion required:
TXA group 68/76
Placebo group 63/74