Fan Huiqiao, Bessada Youssef, Coleman Craig I
Department of Pharmacy Practice, School of Pharmacy, University of Connecticut, Storrs, Connecticut, USA.
Res Pract Thromb Haemost. 2025 Jan 24;9(1):102688. doi: 10.1016/j.rpth.2025.102688. eCollection 2025 Jan.
Evaluations of andexanet alfa for the reversal of factor Xa inhibitor-associated bleeding have been small, with cohorts drawn from single/limited sites. Delays in providing anticoagulation reversal due to hospital transfer may result in poorer outcomes.
To describe the characteristics and outcomes of andexanet alfa users and evaluate the association between delay in andexanet alfa administration due to transfer from a different acute care hospital and the incidence of all-cause inpatient mortality.
This was a retrospective study using National Inpatient Sample data. Hospitalizations with procedural codes for andexanet alfa and a billing code for bleeding were included. Descriptive analysis was performed, as was multivariable logistic regression, to estimate the odds ratio and 95% CI for the association between andexanet alfa delayed due to transfer from a different acute care hospital and all-cause inpatient mortality.
From 2019 to 2021, 4210 hospitalizations occurred in adults receiving andexanet alfa and a bleed. Most were hospitalized with intracranial hemorrhage (62.0%). The incidence of all-cause inpatient mortality was 16.6% (95% CI, 14.3%-19.3%), mean hospital stays lasted 9.1 days (95% CI, 8.4-9.8), and mean hospital costs were $73,600 (95% CI, $65,000-$82,200). Of all cases, 18.5% were transferred from a different acute care hospital prior to receiving andexanet alfa. Cases with hospital transfer had an 82% increased odds of all-cause inpatient mortality (95% CI, 17%-183%) but did not reach statistical significance when the population was limited to intracranial hemorrhage (odds ratio, 1.51; 95% CI, 0.88-2.60).
Delay in administering andexanet alfa due to hospital transfer may be associated with increased all-cause mortality.
关于阿哌沙班用于逆转Xa因子抑制剂相关出血的评估规模较小，研究队列来自单一/有限的地点。因医院转运导致抗凝逆转延迟可能会导致更差的结果。
描述阿哌沙班使用者的特征和结局，并评估因从其他急性护理医院转运而导致阿哌沙班给药延迟与全因住院死亡率之间的关联。
这是一项使用国家住院样本数据的回顾性研究。纳入具有阿哌沙班程序代码和出血计费代码的住院病例。进行了描述性分析以及多变量逻辑回归，以估计因从其他急性护理医院转运而导致阿哌沙班延迟与全因住院死亡率之间关联的比值比和95%置信区间。
2019年至2021年，接受阿哌沙班并发生出血的成人住院病例有4210例。大多数患者因颅内出血住院（62.0%）。全因住院死亡率为16.6%（95%置信区间，14.3%-19.3%），平均住院时间为9.1天（95%置信区间，8.4-9.8），平均住院费用为73,600美元（95%置信区间，65,000-82,200美元）。在所有病例中，18.5%在接受阿哌沙班之前从其他急性护理医院转运而来。发生医院转运的病例全因住院死亡几率增加82%（95%置信区间，17%-183%），但当人群仅限于颅内出血时未达到统计学显著性（比值比，1.51；95%置信区间，0.88-2.60）。
因医院转运导致阿哌沙班给药延迟可能与全因死亡率增加有关。
