Epistaxis in anticoagulated patients: Fewer hospital admissions and shorter hospital stays on rivaroxaban compared to phenprocoumon.

Sauter, Thomas; Hegazy, K; Hautz, Wolf; Krummrey, G; Ricklin, Meret; Nagler, Michael; Borner, U; Exadaktylos, Aristomenis (2018). Epistaxis in anticoagulated patients: Fewer hospital admissions and shorter hospital stays on rivaroxaban compared to phenprocoumon. Clinical otolaryngology, 43(1), pp. 103-108. Wiley 10.1111/coa.12904

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OBJECTIVES Treatment of epistaxis in patients on anticoagulants is challenging and associated with higher admission rates and longer hospital stays compared with patients without anticoagulation. However, there is little information about epistaxis in patients taking new direct oral anticoagulants such as rivaroxaban compared with patients on traditional vitamin K antagonists such as phenprocoumon. DESIGN Retrospective cohort study. SETTING The study was conducted at the emergency department of the University Hospital Inselspital, Bern, Switzerland. PARTICIPANTS All admissions to the emergency department of the University Hospital Inselspital, Bern, Switzerland from 1st July 2012 to 30th June 2016 with non-traumatic epistaxis on anticoagulant therapy with phenprocoumon or rivaroxaban were included. MAIN OUTCOME MEASURES We compared clinical outcome parameters (admission rates, length of hospital stay and mortality) for both anticoagulant groups. RESULTS We included 440 patients with epistaxis, 123 (28%) on rivaroxaban and 317 (72%) on phenprocoumon. Fewer hospital admissions and shorter hospital stays were found in patients under rivaroxaban (12 (10.4%) vs 57 (18.0%) patients, P=.033; 0.7±2.2 vs 1.5±3.7 days, P=.011) compared with phenprocoumon. Anterior epistaxis was more common in the rivaroxaban group in contrast to posterior epistaxis in patients on phenprocoumon (74 (60.2%) vs 139 (43.8%) patients, P=.002; 7 (5.7%) vs 39 (12.3%) patients, P=.042). CONCLUSIONS Our data suggests that epistaxis on direct oral anticoagulation with rivaroxaban is associated with shorter hospital stays and fewer hospital admissions than epistaxis on vitamin K antagonist phenprocoumon.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Hämatologie (Erwachsene)

UniBE Contributor:

Sauter, Thomas; Hautz, Wolf; Ricklin, Meret; Nagler, Michael and Exadaktylos, Aristomenis

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1749-4478

Publisher:

Wiley

Language:

English

Submitter:

Katrin Kölliker-Schütz

Date Deposited:

23 Nov 2017 11:20

Last Modified:

23 Jan 2019 15:05

Publisher DOI:

10.1111/coa.12904

PubMed ID:

28510336

Uncontrolled Keywords:

anticoagulant bleeding coumarins epistaxis rivaroxaban / Nagler Michael

BORIS DOI:

10.7892/boris.106210

URI:

https://boris.unibe.ch/id/eprint/106210

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