Shorter hospital stay and fewer hospitalisations in patients with visible haematuria on direct oral anticoagulants compared to on vitamin K antagonists.
Publisher DOI
PubMed ID
31202855
Abstract
OBJECTIVES
To investigate the influence of type of anticoagulation - direct oral anticoagulants (DOAC) vs. vitamin K antagonists (VKA) - on length of hospital stay (LOS) and hospitalisation rates in patients with visible haematuria, as visible haematuria in anticoagulated patients can be distressing, difficult to control and even life-threatening.
METHODS
This retrospective cohort study was conducted at the emergency department (ED) of a tertiary university hospital in Switzerland. All patients admitted with visible haematuria from January 1 2013 to December 31 2016 were included. We compared the primary clinical outcome parameters (hospitalisation rate and LOS) as well as secondary outcomes (ICU admission, ED LOS, and in-hospital mortality) in patients with visible haematuria on either DOAC therapy, VKA therapy or no anticoagulants.
RESULTS
We included 811 (100%) patients with visible haematuria; 53 (6.5%) patients were on DOAC, compared to 85 (10.5%) on VKA and 673 (83.0%) patients without any anticoagulation. In confounder-adjusted multivariable testing, there were fewer hospitalisations (odds ratio: 2.2, 95% CI: 1.1-4.9, p=0.028) and shorter LOS (geometric mean ratio: 2.2, 95% CI: 1.3-4.0, p=0.006) on DOAC than on VKA. The secondary outcomes were not significantly associated with the anticoagulation groups. No differences were found between the DOAC and no-anticoagulant groups for any outcome.
CONCLUSIONS
Visible haematuria in patients on DOAC therapy is associated with shorter hospital stays and fewer hospitalisations compared to VKA.
To investigate the influence of type of anticoagulation - direct oral anticoagulants (DOAC) vs. vitamin K antagonists (VKA) - on length of hospital stay (LOS) and hospitalisation rates in patients with visible haematuria, as visible haematuria in anticoagulated patients can be distressing, difficult to control and even life-threatening.
METHODS
This retrospective cohort study was conducted at the emergency department (ED) of a tertiary university hospital in Switzerland. All patients admitted with visible haematuria from January 1 2013 to December 31 2016 were included. We compared the primary clinical outcome parameters (hospitalisation rate and LOS) as well as secondary outcomes (ICU admission, ED LOS, and in-hospital mortality) in patients with visible haematuria on either DOAC therapy, VKA therapy or no anticoagulants.
RESULTS
We included 811 (100%) patients with visible haematuria; 53 (6.5%) patients were on DOAC, compared to 85 (10.5%) on VKA and 673 (83.0%) patients without any anticoagulation. In confounder-adjusted multivariable testing, there were fewer hospitalisations (odds ratio: 2.2, 95% CI: 1.1-4.9, p=0.028) and shorter LOS (geometric mean ratio: 2.2, 95% CI: 1.3-4.0, p=0.006) on DOAC than on VKA. The secondary outcomes were not significantly associated with the anticoagulation groups. No differences were found between the DOAC and no-anticoagulant groups for any outcome.
CONCLUSIONS
Visible haematuria in patients on DOAC therapy is associated with shorter hospital stays and fewer hospitalisations compared to VKA.
Date Issued
2019-10
Publication Type
Article
Subject(s)
Subjects
anticoagulants bleeding direct oral anticoagulants visible haematuria
Language(s)
en
Author(s)
Journal
Urology
Publisher
Elsevier
ISSN
0090-4295
Access(Rights)
open.access