Abstract
This study investigated length of stay (LOS) among patients admitted to hospital for venous thromboembolism (VTE) in England. Linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care data were used to identify patients aged ≥18 years who experienced an incident VTE event initially treated in hospital between January 2013- July 2017. Patients prescribed either apixaban or warfarin in primary care after hospital discharge were included (with the assumption that this was the treatment received in hospital). Overall 1,152 VTE patients were identified; 69.2% with pulmonary embolism (PE) and 30.8% with deep vein thrombosis (DVT). 1,043 patients were treated with warfarin and 109 with apixaban. None of the baseline characteristics were significantly different between the two groups (e.g. mean age for warfarin patients was 63.7 years and for apixaban patients it was 63.2 years). The mean LOS of the initial VTE hospitalization was 4.6 days (SD: 5.1, IQR: 0-7) among warfarin patients and 2.6 days (SD: 3.7, IQR: 0-4) among apixaban patients; with the difference being statistically significant (p<0.001). These differences persisted when stratifying by VTE type. Within the PE cohort, the mean hospital LOS was 5.5 days (SD: 4.9, IQR: 2-8) among warfarin patients and 3.9 days (SD: 4.0, IQR: 1-6) among apixaban patients (p=0.004); corresponding estimates in the DVT cohort were 2.6 days (SD: 5.0, IQR: 0-3) among warfarin patients and 0.8 days (SD: 2.2, IQR: 0-0) among apixaban patients (p=0.019). Our findings suggest that hospital length of stay following VTE diagnosis was shorter among apixaban-treated patients compared to warfarin-treated patients, both for PE and DVT diagnosed patients. The small sample size for apixaban and lack of data for treatment specifically given in hospital however means findings should be interpreted with caution and need to be validated.
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