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Shorter hospital stays in epistaxis patients with atrial fibrillation when taking rivaroxaban or apixaban versus phenprocoumon

  • Petar Stankovic
  • Robert Georgiew
  • Cornelius Frommelt
  • Sabine Hammel
  • Jan Wittlinger
  • Stephan Hoch
  • Danilo Obradovic
  • Nikolaos Dagres
  • Thomas WilhelmEmail author
Article
  • 25 Downloads

Abstract

Patients taking oral anticoagulants (OACs) currently represent one-third of all patients treated for epistaxis and an upward trend is expected. New direct oral anticoagulants (DOACs) have been on the market for approximately 10 years. DOACs are favoured over Vitamin K-Antagonists (VKAs) in the current guidelines. There are barely studies that investigate the impact of DOACs on patients with epistaxis. A retrospective study was performed analysing all patients who had stationary treatment for epistaxis from 01.01.2011 to 01.01.2018 in a tertiary care centre. In a total of 466 patients, 46.1% were on OACs. The main indication was atrial fibrillation (AF, 67.4%).The number of DOACs taken surpassed that of the VKAs during the past 2 years. The length of hospital stay was significantly longer in the phenprocoumon group (3 ± 0.2 days) in comparison to both the rivaroxaban (2.3 ± 0.1) and the apixaban (2.2 ± 0.1) groups (p = 0.005). Posterior epistaxis occurred more frequently in the phenprocoumon group (10.8%) than in the rivaroxaban (0%) and apixaban (0%) groups (p = 0.03). A correlation between CHA2DS2–VASc score (risk score for apoplexy in patients with AF, p = 0.01), HAS-BLED score (score for assessment of major bleeding in patients taking anticoagulants with AF, p = 0.006), and length of hospital stay (p = 0.002) with recurrence of epistaxis was found. Shorter hospital stays and exclusively anterior bleeding was noted in AF patients taking rivaroxaban and apixaban, whereas AF patients taking phenprocoumon stayed in hospital longer and had more posterior bleeding.

Keywords

Epistaxis Rivaroxaban Apixaban Phenprocoumon Atrial fibrillation 

Notes

Funding

This project was funded entirely by the Department of Otorhinolaryngology of the Sana Kliniken Leipziger Land, Germany.

Compliance with ethical standards

Conflict of interest

All authors have indicated that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Otolaryngology, Head/Neck & Facial Plastic SurgerySana Kliniken Leipziger LandBornaGermany
  2. 2.Department of Otolaryngology, Head and Neck SurgeryPhillips-University MarburgMarburgGermany
  3. 3.Department of Cardiology, Heart Center LeipzigUniversity LeipzigLeipzigGermany
  4. 4.Department of Electrophysiology, Heart Center LeipzigUniversity LeipzigLeipzigGermany

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