Shorter hospital stay and fewer hospitalisations in patients with visible haematuria on direct oral anticoagulants compared to on vitamin K antagonists.
Urology. 2019 Jun 13;:
Authors: Müller M, Bosshard F, Michael N, Roth B, Exadaktylos AK, Sauter TC
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 1st 2013 to December 31st 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.
PMID: 31202855 [PubMed - as supplied by publisher]