Key Points
- To compare hospital length of stay between hospitalized non-valvular atrial fibrillation patients treated with apixaban versus warfarin.
- Retrospective observational cohort study using database records from over 600 US acute-care hospitals between January 1, 2013, and February 28, 2014.
- Included hospitalized adults with atrial fibrillation receiving apixaban or warfarin, excluding patients with rheumatic mitral valvular heart disease or valve replacements.
- Propensity score matching at a 1:1 ratio matched 832 apixaban-treated patients to 832 warfarin-treated patients based on patient clinical, demographic, and hospital characteristics.
- Mean hospital length of stay was significantly shorter in apixaban patients at 4.5 days (SD 4.2) compared with 5.4 days (SD 5.0) in warfarin patients (p < 0.001).
- Median hospital length of stay was 3 days for apixaban versus 4 days for warfarin (p < 0.001).
- Consistent reductions in length of stay favored apixaban in sensitivity analyses measuring days from first anticoagulant dose and in sub-analyses of patients with a primary diagnosis of atrial fibrillation.
Structured PICO
Does apixaban reduce hospital length of stay in hospitalized patients with non-valvular atrial fibrillation compared to warfarin?
PPopulation1,664 hospitalized adults (≥18 years) with non-valvular atrial fibrillation (NVAF) from a US database of >600 acute-care hospitals. Excluded patients with rheumatic mitral valvular heart disease or valve replacement.
IInterventionApixaban administered during index hospitalization
CComparatorWarfarin administered during index hospitalization (1:1 propensity score matched using patient demographic/clinical and hospital characteristics)
OOutcomeHospital length of stay (LOS), calculated as discharge date minus admission date
In hospitalized patients with non-valvular atrial fibrillation, treatment with apixaban is associated with a significantly shorter hospital length of stay compared to warfarin, likely due to the lack of INR monitoring requirements.