Association between pre‐admission anticoagulation and in‐hospital death, venous thromboembolism, and major bleeding among hospitalized <scp>COVID</scp>‐19 patients in Japan
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- Motohiko Adomi
- Graduate School of Comprehensive Human Sciences University of Tsukuba Tsukuba Japan
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- Toshiki Kuno
- Department of Cardiology Montefiore Medical Center/Albert Einstein Medical College New York New York USA
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- Jun Komiyama
- Graduate School of Comprehensive Human Sciences University of Tsukuba Tsukuba Japan
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- Yuta Taniguchi
- Graduate School of Comprehensive Human Sciences University of Tsukuba Tsukuba Japan
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- Toshikazu Abe
- Health Services Research and Development Center University of Tsukuba Tsukuba Japan
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- Atsushi Miyawaki
- Health Services Research and Development Center University of Tsukuba Tsukuba Japan
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- Shinobu Imai
- Department of Drug Safety and Risk Management, School of Pharmacy Tokyo University of Pharmacy and Life Sciences Tokyo Japan
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- Kojiro Morita
- Global Nursing Research Center, Graduate School of Medicine The University of Tokyo Tokyo Japan
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- Makoto Saito
- Division of Infectious Diseases, Advanced Clinical Research Center, The Institute of Medical Science The University of Tokyo Tokyo Japan
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- Hiroyuki Ohbe
- Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo Tokyo Japan
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- Tadashi Kamio
- Division of Critical Care Shonan Kamakura General Hospital Kamakura Kanagawa Japan
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- Nanako Tamiya
- Department of Health Services Research, Faculty of Medicine University of Tsukuba Tsukuba Japan
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- Masao Iwagami
- Department of Health Services Research, Faculty of Medicine University of Tsukuba Tsukuba Japan
説明
<jats:title>Abstract</jats:title><jats:sec><jats:title>Purpose</jats:title><jats:p>The coagulation activation leads to thrombotic complications such as venous thromboembolism (VTE) in patients with coronavirus disease‐2019 (COVID‐19). Prophylactic anticoagulation therapy has been recommended for hospitalized COVID‐19 patients in clinical guidelines. This retrospective cohort study aimed to examine the association between pre‐admission anticoagulation treatment and three outcomes: in‐hospital death, VTE, and major bleeding among hospitalized COVID‐19 patients in Japan.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Using a large‐scale claims database built by the Medical Data Vision Co. in Japan, we identified patients hospitalized for COVID‐19 who had outpatient prescription data at least once within 3 months before being hospitalized. Exposure was set as pre‐admission anticoagulation treatment (direct oral anticoagulant or vitamin K antagonist), and outcomes were in‐hospital death, VTE, and major bleeding. We conducted multivariable logistic regression analyses, adjusting for a single summarized score (a propensity score of receiving pre‐admission anticoagulation) for VTE and major bleeding, due to the small number of outcomes.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among the 2612 analytic patients, 179 (6.9%) had pre‐admission anticoagulation. Crude incidence proportions were 13.4% versus 8.5% for in‐hospital death, 0.56% versus 0.58% for VTE, and 2.2% versus 1.1% for major bleeding among patients with and without pre‐admission anticoagulation, respectively. Adjusted odds ratios (95% confidence intervals) were 1.25 (0.75–2.08) for in‐hospital death, 0.21 (0.02–1.97) for VTE, and 2.63 (0.80–8.65) for major bleeding. Several sensitivity analyses did not change the results.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>We found no evidence that pre‐admission anticoagulation treatment was associated with in‐hospital death. However, a larger sample size may be needed to conclude its effect on VTE and major bleeding.</jats:p></jats:sec>
収録刊行物
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- Pharmacoepidemiology and Drug Safety
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Pharmacoepidemiology and Drug Safety 31 (6), 680-688, 2022-04-07
Wiley
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詳細情報 詳細情報について
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- CRID
- 1360576226212022528
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- DOI
- 10.1002/pds.5433
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- ISSN
- 10991557
- 10538569
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- データソース種別
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- Crossref
- KAKEN