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Journal of Thrombosis and Thrombolysis

, Volume 45, Issue 1, pp 51–55 | Cite as

Initiation of direct oral anticoagulants versus warfarin for venous thromboembolism: impact on time to hospital discharge

  • Amanda N. Basto
  • Nathan P. Fewel
  • Kim Vo
  • Eileen M. Stock
  • Mia Ta
Article

Abstract

The objective of this project was to compare the time from initiation of oral anticoagulation to hospital discharge between warfarin and direct oral anticoagulants (DOACs) for the treatment of acute venous thromboembolism (VTE). This retrospective observational study was done at a single VA medical center. A total of 107 patients were included, with 42 patients (39%) in the DOAC group, which included rivaroxaban, dabigatran, and apixaban, and 65 patients (61%) in the warfarin group. Variables collected through chart review included comorbid conditions, time from initiation of oral anticoagulation to discharge, emergency department (ED) visits and readmission within 30 or 90 days, and bleeding events. The DOAC group had a shorter time to discharge compared to the warfarin group (28 vs. 114 h, p < 0.001). There were similar 30 and 90-day hospital readmission rates and/or ED visits for DOACs (23.8 and 33.3%) compared to warfarin (18.5 and 30.8%), including those related to bleeding of any severity (11.9% for DOACs vs. 9.2% for warfarin; p = 0.75). There was one major bleeding event in the DOAC group and two in the warfarin group. The use of DOACs for the treatment of acute VTE in hospitalized patients was associated with shorter time to hospital discharge when compared to warfarin.

Keywords

Anticoagulation Warfarin DOAC Venous thromboembolism Length of stay 

Notes

Acknowledgements

This work was completed with support from the Central Texas Veterans Health Care System. The views expressed are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.

Funding

There was no source of funding for this study.

Compliance with ethical standards

Conflict of interest

Amanda N. Basto, Nathan P. Fewel, Kim Vo, Eileen M. Stock and Mia Ta declares that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The local institutional review board waived the requirement of informed consent for this study.

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Copyright information

© Springer Science+Business Media, LLC (outside the USA) 2017

Authors and Affiliations

  • Amanda N. Basto
    • 1
  • Nathan P. Fewel
    • 1
  • Kim Vo
    • 2
  • Eileen M. Stock
    • 3
  • Mia Ta
    • 1
  1. 1.Department of Veterans AffairsCentral Texas Veterans Health Care SystemTempleUSA
  2. 2.Oregon State University/Oregon Health & Sciences University College of PharmacyPortlandUSA
  3. 3.Department of Veterans AffairsCooperative Studies Program Coordinating CenterPerry PointUSA

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