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• W4387247910 abstract "SESSION TITLE: Pharmacotherapeutics Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Hemoptysis is caused by blood originating from the respiratory tract. Without immediate intervention, it can be associated with a high mortality from asphyxiation. Tranexamic acid (TXA) is a synthetic anti-fibrinolytic agent used in the management of various bleeding complications. There is an extensive amount of evidence supporting the use of TXA to decrease bleeding complications in trauma and post-operatively. However, there are few studies looking at the use of nebulized TXA for hemoptysis that show conflicting findings. Despite the little evidence, TXA is widely used at our institutions to manage patients presenting with hemoptysis. This is a retrospective analysis of the effectiveness of tranexamic acid in the management of hemoptysis compared to supportive management. METHODS: We performed a retrospective chart review of patients hospitalized with hemoptysis over four years between three medical centers. Patients were identified using ICD-10 codes. Baseline characteristics, clinical variables, severity variables and outcomes were then compared between patients who received TXA and those who did not. For statistical analysis, we used chi-square test for dichotomous data and two-sided t-testing for continuous variables. RESULTS: 488 patients were identified between 2018-2021. 96 received TXA and 392 did not. No significant differences in demographic and clinical differences were observed between the two groups, p>0.05. Diffuse alveolar hemorrhage was the most common diagnosis in the TXA group and pneumonia in the non-TXA group. There was no statistical difference in the clinical diagnosis between the two groups, p>0.05. Average length of hospital and ICU length of stay was higher in the TXA group, p<0.05. More patients in the TXA group required ICU admission, mechanical ventilation and/or bronchoscopy, p<0.001. No difference was found for the need for IR intervention, p=0.3. There was also a statistically significant increased risk of mortality in the TXA group, 43% vs 14%, p<0.001. CONCLUSIONS: There appears to be an indication bias for TXA based on disease severity without an obvious improvement in clinical outcomes. A propensity analysis to match disease severity and underlying condition will now be performed to adjust for confounders that may exist between the two groups. CLINICAL IMPLICATIONS: Our findings have the potential to affect how we manage hemoptysis in our patient population going forward and could inform additional trials of TXA in the treatment of hemoptysis. DISCLOSURES: No relevant relationships by Nancy Bethuel No relevant relationships by Cynthia Brown No relevant relationships by Chris Naum" @default.
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• W4387247910 date "2023-10-01" @default.
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• W4387247910 title "NEBULIZED TRANEXAMIC ACID FOR HEMOPTYSIS IN CRITICAL AND NONCRITICALLY ILL PATIENTS: A MULTICENTER RETROSPECTIVE ANALYSIS" @default.
• W4387247910 doi "https://doi.org/10.1016/j.chest.2023.07.3376" @default.
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