Key result
Treatment with apixaban or rivaroxaban reduced mean hospital length of stay compared to parenteral anticoagulation plus warfarin (2.63 vs 5.33 days; difference 2.7 days, p<0.05) in VTE patients.
Why the study?
Does treatment with apixaban or rivaroxaban reduce hospital length of stay compared to parenteral anticoagulation plus warfarin in patients admitted for venous thromboembolism?
Cohort (n=152)
No
Does treatment with apixaban or rivaroxaban reduce hospital length of stay compared to parenteral anticoagulation plus warfarin in patients admitted for venous thromboembolism?
In patients hospitalized for acute venous thromboembolism, treatment with rivaroxaban or apixaban was associated with a 2.7-day shorter hospital stay and lower total hospitalization charges compared to parenteral bridging plus warfarin.
Objectives: Existing research comparing hospital length of stay for patients treated with non–vitamin K oral anticoagulants or parenteral bridging to warfarin has been conducted primarily with the agent rivaroxaban. The objective of this study was to compare hospital length of stay between patients initiated on the non–vitamin K oral anticoagulants, apixaban or rivaroxaban, and patients initiated on parenteral anticoagulation agents plus warfarin for the treatment of venous thromboembolism. Methods: A retrospective cohort study was conducted at an 859-bed, not-for-profit, teaching hospital. Adult patients admitted for a primary diagnosis of venous thromboembolism between 1 November 2012 and 31 August 2015 and treated with apixaban or rivaroxaban or a parenteral anticoagulant plus warfarin were included in the study. Eligible patients were identified using International Classification of Diseases, Ninth Revision codes for a primary diagnosis of acute thromboses and emboli and medication administration record data. Individuals using anticoagulation therapy prior to admission, released from the emergency department, or treated with thrombectomy or fibrinolytic therapy were excluded. Results: A total of 152 patients were included in this study. Patient characteristics, including renal function, were similar between study arms. Venous thromboembolism treatment with apixaban or rivaroxaban compared to a parenteral anticoagulant plus warfarin was associated with a reduced hospital length of stay (2.63 vs 5.33 days; p < 0.05) and decreased total hospital cost adjusted to 2015 dollars (US$21,694 vs US$38,851; p = 0.013). Conclusion: These results suggest that treatment with a non–vitamin K anticoagulant may significantly reduce hospital length of stay and total hospital cost compared to a parenteral anticoagulant plus warfarin for patients admitted for venous thromboembolism.
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Saint et al. (2017) conducted a cohort in Venous thromboembolism (deep vein thrombosis or pulmonary embolism) (n=152). Non-vitamin K oral anticoagulants (apixaban or rivaroxaban) vs. Parenteral anticoagulant (enoxaparin, fondaparinux, or unfractionated heparin) plus warfarin was evaluated on Hospital length of stay (days) (MD -2.7 days, p=<0.05). Treatment with apixaban or rivaroxaban reduced mean hospital length of stay compared to parenteral anticoagulation plus warfarin (2.63 vs 5.33 days; difference 2.7 days, p<0.05) in VTE patients.
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