Universität zu Köln

Muller, Martin, Bosshard, Flavio, Nagler, Michael ORCID: 0000-0003-4319-2367, Roth, Beat, Exadaktylos, Aristomenis K. and Sauter, Thomas C. (2019). Shorter Hospital Stay and Fewer Hospitalizations in Patients With Visible Hematuria on Direct Oral Anticoagulants Compared to on Vitamin K Antagonists. Urology, 132. S. 101 - 109. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1527-9995

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Abstract

OBJECTIVE To investigate the influence of type of anticoagulation - direct oral anticoagulants (DOAC) vs vitamin K antagonists (VKA) - on length of hospital stay (LOS) and hospitalization rates in patients with visible hematuria, as visible hematuria 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 hematuria from January 1, 2013 to December 31, 2016 were included. We compared the primary clinical outcome parameters (hospitalization rate and LOS) as well as secondary outcomes (ICU admission, ED LOS, and in-hospital mortality) in patients with visible hematuria on either DOAC therapy, VKA therapy or no anticoagulants. RESULTS We included 811 (100%) patients with visible hematuria; 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 hospitalizations (odds ratio: 2.2, 95% confidence interval [CI]: 1.1-4.9, P = .028) and shorter LOS (geometric mean ratio: 2.2, 95% CI: 1.3-4.0, P = .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. CONCLUSION Visible hematuria in patients on DOAC therapy is associated with shorter hospital stays and fewer hospitalizations compared to VKA. (C) 2019 Elsevier Inc.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Muller, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Bosshard, Flavio UNSPECIFIED UNSPECIFIED UNSPECIFIED Nagler, Michael UNSPECIFIED orcid.org/0000-0003-4319-2367 UNSPECIFIED Roth, Beat UNSPECIFIED UNSPECIFIED UNSPECIFIED Exadaktylos, Aristomenis K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sauter, Thomas C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-132957
DOI:	10.1016/j.urology.2019.06.004
Journal or Publication Title:	Urology
Volume:	132
Page Range:	S. 101 - 109
Date:	2019
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1527-9995
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GROSS HEMATURIA; ASSOCIATION; THERAPY Multiple languages Urology & Nephrology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13295