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.
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