Effect of tranexamic acid on mortality in patients with haemoptysis: a nationwide study.
Cost-effectiveness
Haemoptysis
Propensity score matching
Tranexamic acid
Journal
Critical care (London, England)
ISSN: 1466-609X
Titre abrégé: Crit Care
Pays: England
ID NLM: 9801902
Informations de publication
Date de publication:
06 11 2019
06 11 2019
Historique:
received:
16
07
2019
accepted:
20
09
2019
entrez:
8
11
2019
pubmed:
7
11
2019
medline:
28
4
2020
Statut:
epublish
Résumé
Although tranexamic acid is widely used in patients with haemoptysis, whether it improves mortality has not been well investigated. The aim of this study was to evaluate the effect of tranexamic acid on in-hospital mortality among patients with haemoptysis. This was a retrospective study using data from the Japanese Diagnosis Procedure Combination inpatient database. We identified all cases of emergency admission due to haemoptysis from July 2010 to March 2017. Patients were divided into two groups: a control group, and a tranexamic acid group (those who received tranexamic acid on the day of admission). The primary outcome was in-hospital mortality, with secondary outcomes of hospital stay length and total healthcare cost. The data were evaluated using a propensity score matching analysis. Among 28,539 included patients, 17,049 patients received tranexamic acid and 11,490 patients did not. Propensity score analysis generated 9933 matched pairs. Compared to the control group, patients in the tranexamic acid group had significantly lower in-hospital mortality (11.5% vs. 9.0%; risk difference, - 2.5%; 95% confidence interval (CI), - 3.5 to - 1.6%), shorter hospital stays (18 ± 24 days vs. 16 ± 18 days; risk difference, - 2.4 days; 95% CI, - 3.1 to - 1.8 days), and lower total healthcare costs ($7573 ± 10,085 vs. $6757 ± 9127; risk difference, $- 816; 95% CI, $- 1109 to - 523). Tranexamic acid may reduce in-hospital mortality among patients with haemoptysis requiring emergency admission.
Sections du résumé
BACKGROUND
Although tranexamic acid is widely used in patients with haemoptysis, whether it improves mortality has not been well investigated. The aim of this study was to evaluate the effect of tranexamic acid on in-hospital mortality among patients with haemoptysis.
METHODS
This was a retrospective study using data from the Japanese Diagnosis Procedure Combination inpatient database. We identified all cases of emergency admission due to haemoptysis from July 2010 to March 2017. Patients were divided into two groups: a control group, and a tranexamic acid group (those who received tranexamic acid on the day of admission). The primary outcome was in-hospital mortality, with secondary outcomes of hospital stay length and total healthcare cost. The data were evaluated using a propensity score matching analysis.
RESULTS
Among 28,539 included patients, 17,049 patients received tranexamic acid and 11,490 patients did not. Propensity score analysis generated 9933 matched pairs. Compared to the control group, patients in the tranexamic acid group had significantly lower in-hospital mortality (11.5% vs. 9.0%; risk difference, - 2.5%; 95% confidence interval (CI), - 3.5 to - 1.6%), shorter hospital stays (18 ± 24 days vs. 16 ± 18 days; risk difference, - 2.4 days; 95% CI, - 3.1 to - 1.8 days), and lower total healthcare costs ($7573 ± 10,085 vs. $6757 ± 9127; risk difference, $- 816; 95% CI, $- 1109 to - 523).
CONCLUSIONS
Tranexamic acid may reduce in-hospital mortality among patients with haemoptysis requiring emergency admission.
Identifiants
pubmed: 31694697
doi: 10.1186/s13054-019-2620-5
pii: 10.1186/s13054-019-2620-5
pmc: PMC6836388
doi:
Substances chimiques
Antifibrinolytic Agents
0
Tranexamic Acid
6T84R30KC1
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
347Subventions
Organisme : Ministry of Health, Labour and Welfare
ID : 19AA2007
Pays : International
Organisme : Ministry of Health, Labour and Welfare
ID : H30-Policy-Designated-004
Pays : International
Organisme : Ministry of Education, Culture, Sports, Science and Technology, Japan
ID : 17H04141
Pays : International
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