scholarly journals Length of Stay Comparison between Rivaroxaban and Warfarin in the Treatment of Pulmonary Embolism: Results from a Real-World Observational Cohort Study

Thrombosis ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Kirsten M. Roberts ◽  
Tamara B. Knight ◽  
Eimeira Padilla-Tolentino ◽  
Manasa Murthy ◽  
Evan J. Peterson

Background. Trials have shown that novel oral anticoagulants may decrease length of stay versus warfarin. A comparison of length of stay in the treatment of pulmonary embolism (PE) has not been performed outside post hoc analysis of a large clinical trial. Objective. To evaluate if rivaroxaban decreases length of stay compared to warfarin plus enoxaparin in the treatment of PE. Methods. This was a multicenter, retrospective, observational cohort study. Patients were identified based on discharge diagnosis of PE and were excluded if they received anticoagulants prior to admission and had additional indications for anticoagulation or reduced creatinine clearance. The primary endpoint was length of stay. Secondary endpoints included time from initial dose of oral anticoagulant to discharge and length of stay comparison between subgroups. Results. Inclusion criterion was met by 158 patients (82 warfarin, 76 rivaroxaban). The median length of stay was 4.5 days (interquartile range [IQR], 2.7, 5.9) in the warfarin group and 1.8 days (IQR, 1.2, 3.7) in the rivaroxaban group (P<0.001). Time interval from first dose of oral anticoagulant to discharge was shorter with rivaroxaban (P<0.001). Conclusions. Patients given rivaroxaban had decreased length of stay versus those given warfarin plus enoxaparin for the treatment of PE.

2016 ◽  
Vol 12 (1) ◽  
pp. 200-206 ◽  
Author(s):  
Thomas L. Jones ◽  
Jonathon Owen ◽  
Scott Elliott ◽  
Thomas Brown ◽  
Dominic Reynish ◽  
...  

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038102
Author(s):  
Alison Evans ◽  
Miranda Davies ◽  
Vicki Osborne ◽  
Debabrata Roy ◽  
Saad Shakir

ObjectivesTo evaluate the short-term (12 weeks) safety and utilisation of rivaroxaban prescribed to new-user adult patients for the treatment of deep vein thrombosis and pulmonary embolism and for the prevention of recurrent deep vein thrombosis and pulmonary embolism in a secondary care setting in England and Wales.DesignAn observational cohort study using the technique of Specialist Cohort Event Monitoring.SettingThe Rivaroxaban Observational Safety Evaluation study was conducted across 87 participating National Health Service secondary care trusts in England and Wales.Participants1532 patients treated with rivaroxaban for the prevention and treatment of deep vein thrombosis/pulmonary embolism from September 2013 to January 2016.InterventionsNon-interventional postauthorisation safety study of rivaroxaban.Primary and secondary outcome measures(1) Risk of major bleeding in gastrointestinal, intracranial, and urogenital sites and (2) risk of all major and clinically relevant non-major bleeds.ResultsOf a total of 4846 patients enrolled in the study from September 2013 to January 2016, 1532 were treated with rivaroxaban for the prevention and treatment of deep vein thrombosis/pulmonary embolism. The median age of the deep vein thrombosis/pulmonary embolism cohort was 63 years, and 54.6% were men. The risk of major bleeding within the gastrointestinal, urogenital and intracranial primary sites was 0.7% (n=11), 0.3% (n=5) and 0.1% (n=1), respectively. The risk of major bleeding in all sites was 1.5% (n=23) at a rate of 8.3 events per 100 patient-years.ConclusionsIn terms of the primary outcome risk of major bleeding in gastrointestinal, intracranial and urogenital sites, the risk estimates in the population using rivaroxaban for deep vein thrombosis/pulmonary embolism were low (<1%) and consistent with the risk estimated from clinical trial data and in routine clinical practice.Trial registration numbersClinicalTrials.gov Registry (NCT01871194); ENCePP Registry (EUPAS3979).


PLoS ONE ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. e0217302 ◽  
Author(s):  
Anouk J. W. Gulpen ◽  
Hugo ten Cate ◽  
Yvonne M. C. Henskens ◽  
René van Oerle ◽  
Rick Wetzels ◽  
...  

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