Tranexamic Acid to Treat Life-threatening Hemorrhage in Prostate Cancer Associated Disseminated Intravascular Coagulation with Excessive Fibrinolysis
Bibliographic record
Abstract
This case illustrates the acute onset of life-threatening bleeding in a 57-year-old male with treatment-resistant metastatic prostate cancer. Laboratory results confirmed the presence of disseminated intravascular coagulation (DIC). Despite aggressive transfusion support, his consumptive coagulopathy and persistent bleeding could not be controlled, and his need for blood products began to outpace the available supply. Our patient had declined further chemotherapy treatment for his underlying aggressive prostate cancer and would accept only palliative care. Both thrombosis and bleeding are known to coexist during DIC. In our patient, his hemorrhagic clinical condition and laboratory results supported the presence of DIC with an excessive fibrinolytic process in the setting of metastatic prostate cancer. Following careful consideration of potential risks and benefits, the decision was made to administer the antifibrinolytic agent tranexamic acid to control bleeding. Initiation of this treatment led to rapid bleeding cessation without thrombotic complication. Although controversial, this treatment was life-saving in our patient and allowed hospital discharge. He remained transfusion independent for his remaining four weeks of life following discharge, and ultimately died at home of multi-organ failure related to his cancer.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".