Real-World Assessment of All-Cause Hospital Readmissions among Pulmonary Embolism Patients Treated With Rivaroxaban Versus Apixaban
Background Although hospital readmission after pulmonary embolism (PE) is common, there is limited evidence on the comparative risk of readmission between rivaroxaban and apixaban. This study compared the real-world risk of all-cause hospital readmission among patients with PE treated with rivaroxab...
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| Format: | Article |
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SAGE Publishing
2025-03-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/10760296251327592 |
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| author | Veronica Ashton MPH Guillaume Germain MSc Julien Boudreau MA Manasvi Sundar MPH Sean D MacKnight MScPH Shawn Murphy MD, PhD Yichuan G. Hsieh PhD François Laliberté MA |
| author_facet | Veronica Ashton MPH Guillaume Germain MSc Julien Boudreau MA Manasvi Sundar MPH Sean D MacKnight MScPH Shawn Murphy MD, PhD Yichuan G. Hsieh PhD François Laliberté MA |
| author_sort | Veronica Ashton MPH |
| collection | DOAJ |
| description | Background Although hospital readmission after pulmonary embolism (PE) is common, there is limited evidence on the comparative risk of readmission between rivaroxaban and apixaban. This study compared the real-world risk of all-cause hospital readmission among patients with PE treated with rivaroxaban or apixaban. Methods This retrospective study used data from Mass General Brigham's Research Patient Data Registry (01/2013-05/2023) to identify adult patients newly initiated on rivaroxaban or apixaban during a PE-related hospitalization (discharge = index). Patients with venous thromboembolism in the 3 months prior to the index PE hospitalization were excluded. All-cause hospital readmissions at 30, 60, and 90 days post-index were assessed using Kaplan-Meier analysis and were compared between cohorts using hazard ratios (HRs), 95% confidence intervals (CIs), and p-values from Cox proportional hazards regression models. Inverse probability of treatment weighting was used to adjust for baseline confounding. Results In total, 686 rivaroxaban (mean age: 59.5; female: 50.1; Quan-Charlson comorbidity index: 1.51) and 2207 apixaban (mean age: 60.6; female: 50.8; Quan-CCI: 1.58) initiators were included. Rivaroxaban was associated with a 26% lower risk of all-cause hospital readmission at 30 days post-index (12.3% vs 16.5%; HR [95% CI]: 0.74 [0.58, 0.94]; P = .012). Risk of hospital readmission was also significantly lower at 60 days (17.0% vs 22.3%; HR [95% CI]: 0.74 [0.61, 0.91]; P = .004) and 90 days post-index (21.6% vs 25.6%; HR [95% CI]: 0.81 [0.68, 0.98]; P = .029). Conclusions Rivaroxaban was associated with significantly lower risk of all-cause hospital readmission within 90 days post-discharge from PE-related hospitalization than apixaban. |
| format | Article |
| id | doaj-art-c865025a686047c8a6b9b9eac82d475a |
| institution | DOAJ |
| issn | 1938-2723 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | SAGE Publishing |
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| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj-art-c865025a686047c8a6b9b9eac82d475a2025-08-20T02:40:30ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232025-03-013110.1177/10760296251327592Real-World Assessment of All-Cause Hospital Readmissions among Pulmonary Embolism Patients Treated With Rivaroxaban Versus ApixabanVeronica Ashton MPH0Guillaume Germain MSc1Julien Boudreau MA2Manasvi Sundar MPH3Sean D MacKnight MScPH4Shawn Murphy MD, PhD5Yichuan G. Hsieh PhD6François Laliberté MA7 , a Johnson & Johnson Company, Titusville, NJ, USA Groupe d’Analyse, Ltée, Montréal, Québec, Canada Groupe d’Analyse, Ltée, Montréal, Québec, Canada Analysis Group, Inc., Los Angeles, CA, USA Groupe d’Analyse, Ltée, Montréal, Québec, Canada Mass General Brigham, Somerville, MA, USA Mass General Brigham, Somerville, MA, USA Groupe d’Analyse, Ltée, Montréal, Québec, CanadaBackground Although hospital readmission after pulmonary embolism (PE) is common, there is limited evidence on the comparative risk of readmission between rivaroxaban and apixaban. This study compared the real-world risk of all-cause hospital readmission among patients with PE treated with rivaroxaban or apixaban. Methods This retrospective study used data from Mass General Brigham's Research Patient Data Registry (01/2013-05/2023) to identify adult patients newly initiated on rivaroxaban or apixaban during a PE-related hospitalization (discharge = index). Patients with venous thromboembolism in the 3 months prior to the index PE hospitalization were excluded. All-cause hospital readmissions at 30, 60, and 90 days post-index were assessed using Kaplan-Meier analysis and were compared between cohorts using hazard ratios (HRs), 95% confidence intervals (CIs), and p-values from Cox proportional hazards regression models. Inverse probability of treatment weighting was used to adjust for baseline confounding. Results In total, 686 rivaroxaban (mean age: 59.5; female: 50.1; Quan-Charlson comorbidity index: 1.51) and 2207 apixaban (mean age: 60.6; female: 50.8; Quan-CCI: 1.58) initiators were included. Rivaroxaban was associated with a 26% lower risk of all-cause hospital readmission at 30 days post-index (12.3% vs 16.5%; HR [95% CI]: 0.74 [0.58, 0.94]; P = .012). Risk of hospital readmission was also significantly lower at 60 days (17.0% vs 22.3%; HR [95% CI]: 0.74 [0.61, 0.91]; P = .004) and 90 days post-index (21.6% vs 25.6%; HR [95% CI]: 0.81 [0.68, 0.98]; P = .029). Conclusions Rivaroxaban was associated with significantly lower risk of all-cause hospital readmission within 90 days post-discharge from PE-related hospitalization than apixaban.https://doi.org/10.1177/10760296251327592 |
| spellingShingle | Veronica Ashton MPH Guillaume Germain MSc Julien Boudreau MA Manasvi Sundar MPH Sean D MacKnight MScPH Shawn Murphy MD, PhD Yichuan G. Hsieh PhD François Laliberté MA Real-World Assessment of All-Cause Hospital Readmissions among Pulmonary Embolism Patients Treated With Rivaroxaban Versus Apixaban Clinical and Applied Thrombosis/Hemostasis |
| title | Real-World Assessment of All-Cause Hospital Readmissions among Pulmonary Embolism Patients Treated With Rivaroxaban Versus Apixaban |
| title_full | Real-World Assessment of All-Cause Hospital Readmissions among Pulmonary Embolism Patients Treated With Rivaroxaban Versus Apixaban |
| title_fullStr | Real-World Assessment of All-Cause Hospital Readmissions among Pulmonary Embolism Patients Treated With Rivaroxaban Versus Apixaban |
| title_full_unstemmed | Real-World Assessment of All-Cause Hospital Readmissions among Pulmonary Embolism Patients Treated With Rivaroxaban Versus Apixaban |
| title_short | Real-World Assessment of All-Cause Hospital Readmissions among Pulmonary Embolism Patients Treated With Rivaroxaban Versus Apixaban |
| title_sort | real world assessment of all cause hospital readmissions among pulmonary embolism patients treated with rivaroxaban versus apixaban |
| url | https://doi.org/10.1177/10760296251327592 |
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