PMID- 23006024
OWN - NLM
STAT- MEDLINE
DCOM- 20130429
LR  - 20211021
IS  - 1179-187X (Electronic)
IS  - 1175-3277 (Print)
IS  - 1175-3277 (Linking)
VI  - 12
IP  - 6
DP  - 2012 Dec 1
TI  - Anticoagulant use, the prevalence of bridging, and relation to length of stay 
      among hospitalized patients with non-valvular atrial fibrillation.
PG  - 403-13
AB  - OBJECTIVE: The objectives of this study were to describe inpatient 
      anticoagulation and bridging in patients with non-valvular atrial fibrillation 
      (NVAF) and to identify whether differences exist in length of stay (LOS) among 
      bridged versus non-bridged NVAF patients. DESIGN: Administrative claims data were 
      used to select patients >/=18 years with a primary or secondary discharge diagnosis 
      of NVAF and inpatient warfarin use from 1 July 2004 to 30 September 2009. 
      Patients with valvular or transient causes of NVAF or pregnancy were excluded. 
      Inpatient bridging was defined as receipt of an anticoagulant in addition to 
      warfarin during the hospitalization. LOS was reported for non-bridged patients 
      (warfarin only) and compared with three bridging regimens: low molecular weight 
      heparin/pentasaccharide (LMWH/PS); unfractionated heparin (UFH); and two-agent 
      bridging (LMWH/PS and UFH). Multivariate analyses were performed to evaluate the 
      association between bridging and LOS, adjusting for demographic and clinical 
      variables. RESULTS: Of 6340 NVAF patients, 48% received inpatient warfarin (mean 
      LOS 5.5 days); among them, 64% received bridging therapy (mean LOS 6.3 days) 
      [LMWH/PS 45% (mean LOS 5.6 days), UFH 36% (mean LOS 6.0 days), two-agent bridging 
      18% (mean LOS 8.4 days)]. Following multivariate analysis, relative to patients 
      who received inpatient warfarin only, LOS was significantly higher for patients 
      with UFH (19.3%) and patients with two-agent bridging (45.1%). Patients with 
      pre-period warfarin, cancer, or diabetes mellitus who received bridging agents 
      had significantly longer LOS than patients with those conditions who were not 
      bridged. CONCLUSION: LOS was longer for bridged than non-bridged patients. 
      Further studies are needed to identify predictors of bridging and to explain why 
      bridged NVAF patients had longer LOS.
FAU - Smoyer-Tomic, Karen
AU  - Smoyer-Tomic K
AD  - Truven Health Analytics Inc., Washington, DC 20008, USA.
FAU - Siu, Kimberly
AU  - Siu K
FAU - Walker, David R
AU  - Walker DR
FAU - Johnson, Barbara H
AU  - Johnson BH
FAU - Smith, David M
AU  - Smith DM
FAU - Sander, Stephen
AU  - Sander S
FAU - Amin, Alpesh
AU  - Amin A
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - New Zealand
TA  - Am J Cardiovasc Drugs
JT  - American journal of cardiovascular drugs : drugs, devices, and other 
      interventions
JID - 100967755
RN  - 0 (Anticoagulants)
RN  - 5Q7ZVV76EI (Warfarin)
SB  - IM
CIN - Am J Cardiovasc Drugs. 2013 Aug;13(4):259-61. PMID: 23801481
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Atrial Fibrillation/complications/*drug therapy/physiopathology
MH  - Databases, Factual
MH  - *Drug Monitoring
MH  - Drug Prescriptions
MH  - Drug Therapy, Combination/adverse effects
MH  - Female
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Models, Biological
MH  - *Practice Patterns, Physicians'
MH  - Retrospective Studies
MH  - United States
MH  - Warfarin/adverse effects/*therapeutic use
MH  - Young Adult
PMC - PMC3713944
EDAT- 2012/09/26 06:00
MHDA- 2013/04/30 06:00
PMCR- 2012/12/29
CRDT- 2012/09/26 06:00
PHST- 2012/09/26 06:00 [entrez]
PHST- 2012/09/26 06:00 [pubmed]
PHST- 2013/04/30 06:00 [medline]
PHST- 2012/12/29 00:00 [pmc-release]
AID - 2474 [pii]
AID - 10.1007/BF03262474 [doi]
PST - ppublish
SO  - Am J Cardiovasc Drugs. 2012 Dec 1;12(6):403-13. doi: 10.1007/BF03262474.