Sep 30, 2024
Use of resources and cost in the management of gastrointestinal hemorrhage caused by oral anticoagulants
- 1Universidad Tecnologica de Pereira - Audifarma SA
- UTP-Audifarma
Protocol Citation: Jorge Machado Alba 2024. Use of resources and cost in the management of gastrointestinal hemorrhage caused by oral anticoagulants. protocols.io https://dx.doi.org/10.17504/protocols.io.ewov1963klr2/v1
License: This is an open access protocol distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Protocol status: Working
We use this protocol and it's working
Created: September 27, 2024
Last Modified: September 30, 2024
Protocol Integer ID: 108569
Keywords: Atrial Fibrillation; Gastrointestinal Hemorrhage; Health Care Costs; Health Resources; Colombia
Funders Acknowledgement:
Pfizer
Grant ID: CONTRATO No. 2022 - 128
Disclaimer
This research received funds of Pfizer Colombia
Abstract
Introduction: Oral anticoagulants (OACs) used to treat
nonvalvular atrial fibrillation (NVAF) are frequently associated with
complications, especially gastrointestinal hemorrhage (GH).
Objective: To determine the use of resources and costs in
the in-hospital treatment of GH in a group of patients with NVAF from Colombia.
Methods: This was a retrospective study of a cohort of
patients who were diagnosed with NVAF and treated with an OAC (apixaban,
rivaroxaban, dabigatran or warfarin) between 2018 and 2022 and who were
hospitalized for GH. Information on diagnoses, GH location, administered
medications, procedures, hospital stay, and health care costs was collected, adjusted
to 2022.
Results: In total, 59 patients from nine different cities
were identified, the mean age was 82.9 ± 12.6 years, and most were men (61.0%) who
were admitted to nine clinics for GH. High GH was the most frequently
identified form (78.0%). The most commonly used OACs were apixaban (44.1%),
rivaroxaban (35.6%), warfarin (15.3%) and dabigatran (5.1%). The mean hospital
stay was 6.4 ± 5.9 days, and 18.3% of the patients were admitted to the
intensive care unit. Patients also received medications that increase the risk
of bleeding, such as acetylsalicylic acid (45.8%), the antiplatelet inhibitor
P2Y12 (15.3%) and systemic glucocorticoids (23.7%). The average direct cost of
all hospital care was USD 872 ± 1315 per patient, which corresponds to 13% of
the country's gross domestic product per capita.
Conclusions: GH patients with NVAF generates a significant
cost for the use of resources such as medications, procedures and care that
affect the country's health system.
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