Department of Pharmacy Services, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02120, USA.
Department of Pharmacy Practice, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
J Thromb Thrombolysis. 2018 Jul;46(1):16-21. doi: 10.1007/s11239-018-1661-y.
This study was conducted to describe the real-world hospital length of stay in patients treated with all of the U.S. Food and Drug Administration approved direct oral anticoagulants (DOACs) versus warfarin for new-onset venous thromboembolism (VTE) at a large, tertiary, academic medical center. A retrospective cohort analysis of all adult patients diagnosed with acute onset VTE was conducted. Of the 441 patients included, 261 (57%) patients received DOACs versus 180 (41%) patients received warfarin. In the DOAC group, a total of 92 (35%) patients received rivaroxaban, followed by 83 (32%) patients received apixaban, 50 (19%) patients received dabigatran, and 36 (14%) patients received edoxaban. Patients initiated on DOACs had a statistically significant shorter hospital length of stay compared to patients initiated on warfarin (median 3 days, [IQR 0-5] vs. 8 days [IQR 5-11], P < 0.05). Despite the shorter hospital length of stay in patients receiving DOACs, the overall reported differences between the DOACs group and the warfarin group in terms of recurrent VTE, major bleeding, intracranial bleeding, and gastrointestinal bleeding at 3 and 6 months were deemed to be statistically insignificant.
这项研究旨在描述在一家大型三级学术医疗中心中，使用所有获得美国食品药品监督管理局批准的直接口服抗凝剂（DOAC）与华法林治疗新发静脉血栓栓塞症（VTE）的患者的实际住院时长。对所有确诊为急性 VTE 的成年患者进行了回顾性队列分析。在纳入的 441 名患者中，261 名（57%）患者接受 DOAC 治疗，180 名（41%）患者接受华法林治疗。在 DOAC 组中，共有 92 名（35%）患者接受利伐沙班治疗，其次是 83 名（32%）患者接受阿哌沙班治疗，50 名（19%）患者接受达比加群治疗，36 名（14%）患者接受依度沙班治疗。与接受华法林治疗的患者相比，接受 DOAC 治疗的患者的住院时长有显著统计学意义的缩短（中位数 3 天 [IQR 0-5] vs. 8 天 [IQR 5-11]，P<0.05）。尽管接受 DOAC 治疗的患者住院时间较短，但在 3 个月和 6 个月时，DOAC 组和华法林组在复发性 VTE、大出血、颅内出血和胃肠道出血方面的总体报告差异被认为无统计学意义。
