In adult patients presenting as emergencies with upper gastrointestinal bleeding, does tranexamic acid decrease mortality?

Upper gastrointestinal bleeding (UGIB) is a common Emergency Centre presentation with a high mortality (5–30%). Despite theoretical benefits, tranexamic acid is not widely used for this condition. Tranexamic acid is widely available in the developing world and is on the World Health Organisation’s essential medicines list. This review considers the following three-part question: “In adult patients with upper gastrointestinal bleeding, does tranexamic acid decrease mortality? A systematic review of the literature was performed (1900–2012). Databases searched included: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, National Research Register, NIHR CRN portfolio, and http://ClinicalTrials.gov/. Grey literature databases searched included: Open Grey, Worldcat.org and Google Scholar. The conclusion of this review is that in adult patients with upper gastrointestinal bleeding, the administration of tranexamic acid may lead to a significant decrease in mortality.