Shorter hospital stay and fewer hospitalisations in patients with visible haematuria on direct oral anticoagulants compared to on vitamin K antagonists.

Müller, Martin; Bosshard, Flavio; Nagler, Michael; Roth, Beat; Exadaktylos, Aristomenis K.; Sauter, Thomas C. (2019). Shorter hospital stay and fewer hospitalisations in patients with visible haematuria on direct oral anticoagulants compared to on vitamin K antagonists. Urology, 132, pp. 101-108. Elsevier 10.1016/j.urology.2019.06.004

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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.

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 > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology

UniBE Contributor:

Müller, Martin; Nagler, Michael; Roth, Beat; Exadaktylos, Aristomenis and Sauter, Thomas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0090-4295

Publisher:

Elsevier

Language:

English

Submitter:

Jeannine Wiemann

Date Deposited:

08 Aug 2019 11:42

Last Modified:

22 Oct 2019 19:49

Publisher DOI:

10.1016/j.urology.2019.06.004

PubMed ID:

31202855

Uncontrolled Keywords:

anticoagulants bleeding direct oral anticoagulants visible haematuria

BORIS DOI:

10.7892/boris.132020

URI:

https://boris.unibe.ch/id/eprint/132020

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