Abstract 15884: Hospital Length of Stay: Does Rivaroxaban Reduce Inpatient Stay Compared to Warfarin Among Patients With Non-Valvular Atrial Fibrillation?
Background: Warfarin has been the mainstay treatment for prevention of stroke among patients with non-valvular atrial fibrillation (NVAF). Unlike rivaroxaban, warfarin requires laboratory monitoring to document achievement of international normalized ratio goal, thereby potentially prolonging a patient’s hospital length of stay (LOS).
Objective: To compare hospital LOS among hospitalized NVAF patients initiating rivaroxaban versus warfarin in a real-world setting.
Methods: A retrospective claims analysis was conducted using the Premier Perspective Comparative Hospital Database from 11/2010 to 9/2012. Adult patients were included in the study if they had an index hospitalization for NVAF. Patients initiating rivaroxaban during hospitalization were matched with up to 4 warfarin users by propensity score analyses. Similar matched sub-analyses were conducted for patients who (1) used additional parenteral anticoagulants, and (2) initiated their oral anticoagulants on day 3 of their hospital stay or later. Adequacy of match and comparison of hospital LOS were assessed using standardized differences.
Results: The characteristics of the matched cohorts were well balanced. Among the matched rivaroxaban and warfarin users (2,809 and 11,085 patients, respectively), the mean age of the cohorts was 71 years and 49% were females. The average [median] hospital LOS for rivaroxaban patients was 4.5  days, as compared to 5.3  days for the warfarin cohort. The mean difference in hospital LOS of 0.81 days was significant at p<0.01 (standardized difference = 17%). In the sub-analyses of patients using additional parenteral anticoagulants, the average hospital LOS was 1.38 days shorter (standardized difference = 24.6%, p<0.01) for the rivaroxaban group as compared to the warfarin group. Patients who initiated rivaroxaban on day 3 of their hospital stay or later, had a 1.72 day shorter LOS as compared to their matched warfarin counterparts (standardized difference = 28.8%, p<0.01).
Conclusions: This study suggests that NVAF patients receiving rivaroxaban have a significantly lower hospital length of stay as compared to patients receiving warfarin.
- © 2013 by American Heart Association, Inc.