Baseline characteristics of older adults in Ontario who started, continued or resumed oral anticoagulant therapy after hospital discharge between September 2010 and March 2015
| Characteristic | Entire cohort; no (%) of patients* | Prevalent users; no (%) of patients* | |||||
|---|---|---|---|---|---|---|---|
| Overall n = 123 139 | Incident users n = 70 140 | Prevalent users n = 52 999 | Standardized difference | Switchers n = 3674 | Nonswitchers n = 49 325 | Standardized difference | |
| Age, mean ± SD, yr | 78.2 ± 7.7 | 76.1 ± 7.1 | 81.1 ± 7.6 | 0.69 | 79.4 ± 7.3 | 81.23 ± 7.6 | 0.24 |
| Female sex | 68 408 (55.6) | 39 956 (57.0) | 28 452 (53.7) | 0.07 | 1846 (50.2) | 26 606 (53.9) | 0.07 |
| Rural residence† | 19 931 (16.2) | 11 892 (17.0) | 8039 (15.2) | 0.05 | 580 (15.8) | 7459 (15.1) | 0.02 |
| Anticoagulant dispensed | |||||||
| Apixaban | 5890 (4.8) | 2810 (4.0) | 3080 (5.8) | 0.08 | 570 (15.5) | 2510 (5.1) | 0.35 |
| Dabigatran | 6608 (5.4) | 2775 (4.0) | 3833 (7.2) | 0.14 | 473 (12.9) | 3360 (6.8) | 0.20 |
| Rivaroxaban | 51 409 (41.7) | 42 546 (60.7) | 8863 (16.7) | 1.01 | 1150 (31.3) | 7713 (15.6) | 0.38 |
| Warfarin | 59 232 (48.1) | 22 009 (31.4) | 37 223 (70.2) | 0.84 | 1481 (40.3) | 35 742 (72.5) | 0.69 |
| Indication‡ | |||||||
| Atrial fibrillation within 10 yr | 62 957 (51.1) | 22 530 (32.1) | 40 427 (76.3) | 0.99 | 2988 (81.3) | 37 439 (75.9) | 0.13 |
| Joint replacement within 35 d | 44 375 (36.0) | 38 939 (55.5) | 5436 (10.3) | 1.10 | 502 (13.7) | 4934 (10.0) | 0.11 |
| Major surgery during index hospital stay | 22 043 (17.9) | 17 384 (24.8) | 4659 (8.8) | 0.44 | 590 (16.1) | 4069 (8.2) | 0.24 |
| Active cancer within 180 d | 7858 (6.4) | 3548 (5.1) | 4310 (8.1) | 0.12 | 278 (7.6) | 4032 (8.2) | 0.02 |
| Deep vein thrombosis or pulmonary embolism during index hospital stay | 6407 (5.2) | 1783 (2.5) | 4624 (8.7) | 0.27 | 349 (9.5) | 4275 (8.7) | 0.03 |
| Prescribing physician specialty† | |||||||
| Family medicine | 41 524 (33.7) | 12 604 (18.0) | 28 920 (54.6) | 0.82 | 1274 (34.7) | 27 646 (56.0) | 0.44 |
| Orthopedic surgery | 31 394 (25.5) | 28 014 (39.9) | 3380 (6.4) | 0.87 | 287 (7.8) | 3093 (6.3) | 0.06 |
| Internal medicine | 9958 (8.1) | 5350 (7.6) | 4608 (8.7) | 0.04 | 432 (11.8) | 4176 (8.5) | 0.11 |
| Cardiology | 7083 (5.8) | 3840 (5.5) | 3243 (6.1) | 0.03 | 441 (12.0) | 2802 (5.7) | 0.22 |
| Hematology | 2324 (1.9) | 1808 (2.6) | 516 (1.0) | 0.12 | 107 (2.9) | 409 (0.8) | 0.15 |
| Other | 8792 (7.1) | 4843 (6.9) | 3949 (7.5) | 0.02 | 387 (10.5) | 3562 (7.2) | 0.12 |
| Unknown | 22 064 (17.9) | 13 681 (19.5) | 8383 (15.8) | 0.10 | 746 (20.3) | 7637 (15.5) | 0.13 |
| Past medical history | |||||||
| No. of hospital admissions within 1 yr, mean ± SD | 0.67 ± 1.16 | 0.30 ± 0.73 | 1.16 ± 1.42 | 0.76 | 0.99 ± 1.32 | 1.17 ± 1.43 | 0.13 |
| No. of thromboembolic events within 3 yr | 13 741 (11.2) | 10 483 (19.8) | 3258 (4.6) | 0.48 | 730 (19.9) | 9753 (19.8) | 0.00 |
| Ischemic stroke | 4419 (3.6) | 990 (1.4) | 3429 (6.5) | 0.26 | 228 (6.2) | 3201 (6.5) | 0.01 |
| Transient ischemic attack | 2757 (2.2) | 853 (1.2) | 1904 (3.6) | 0.16 | 142 (3.9) | 1762 (3.6) | 0.02 |
| Peripheral vascular disease event | 2540 (2.1) | 680 (1.0) | 1860 (3.5) | 0.17 | 106 (2.9) | 1754 (3.6) | 0.04 |
| Systemic embolism | 705 (0.6) | 155 (0.2) | 550 (1.0) | 0.10 | 34 (0.9) | 516 (1.0) | 0.01 |
| Pulmonary embolism | 2393 (1.9) | 349 (0.5) | 2044 (3.9) | 0.23 | 152 (4.1) | 1892 (3.8) | 0.02 |
| Deep vein thrombosis | 3280 (2.7) | 580 (0.8) | 2700 (5.1) | 0.25 | 204 (5.6) | 2496 (5.1) | 0.02 |
| Hemorrhagic event within 3 yr | 13 406 (10.9) | 3627 (5.2) | 9779 (18.5) | 0.42 | 616 (16.8) | 9163 (18.6) | 0.05 |
| Intracranial bleeding | 777 (0.6) | 230 (0.3) | 547 (1.0) | 0.09 | 27 (0.7) | 520 (1.1) | 0.03 |
| Upper gastrointestinal bleeding | 3830 (3.1) | 1068 (1.5) | 2762 (5.2) | 0.21 | 182 (5.0) | 2580 (5.2) | 0.01 |
| Lower gastrointestinal bleeding | 1498 (1.2) | 453 (0.6) | 1045 (2.0) | 0.12 | 85 (2.3) | 960 (1.9) | 0.03 |
| Other major bleed | 8750 (7.1) | 2132 (3.0) | 6618 (12.5) | 0.36 | 392 (10.7) | 6226 (12.6) | 0.06 |
| Comorbidities | |||||||
| Congestive heart failure | 47 133 (38.3) | 14 265 (20.3) | 32 868 (62.0) | 0.93 | 2096 (57.0) | 30 772 (62.4) | 0.11 |
| Hypertension | 106 292 (86.3) | 57 447 (81.9) | 48 845 (92.2) | 0.31 | 3378 (91.9) | 45 467 (92.2) | 0.01 |
| Diabetes | 46 522 (37.8) | 22 569 (32.2) | 23 953 (45.2) | 0.27 | 1627 (44.3) | 22 326 (45.3) | 0.02 |
| Renal dysfunction§ | 11 216 (9.1) | 2491 (3.6) | 8725 (16.5) | 0.44 | 418 (11.4) | 8307 (16.8) | 0.16 |
| Liver dysfunction¶ | 1349 (1.1) | 343 (0.5) | 1006 (1.9) | 0.13 | 68 (1.9) | 938 (1.9) | 0.00 |
| Drug use disorder | 14 226 (11.6) | 11 642 (16.6) | 2584 (4.9) | 0.39 | 202 (5.5) | 2382 (4.8) | 0.03 |
| Alcohol use disorder in previous 3 yr | 1401 (1.1) | 517 (0.7) | 884 (1.7) | 0.09 | 64 (1.7) | 820 (1.7) | 0.01 |
| Charlson Comorbidity Index score | |||||||
| 0 | 20 946 (17.0) | 11 714 (16.7) | 9232 (17.4) | 0.02 | 669 (18.2) | 8563 (17.4) | 0.02 |
| 1 | 14 766 (12.0) | 6041 (8.6) | 8725 (16.5) | 0.24 | 637 (17.3) | 8088 (16.4) | 0.03 |
| ≥ 2 | 32 563 (26.4) | 8967 (12.8) | 23 596 (44.5) | 0.75 | 1355 (36.9) | 22 241 (45.1) | 0.17 |
| NA (no hospital admission) | 54 864 (44.6) | 43 418 (61.9) | 11 446 (21.6) | 0.90 | 1013 (27.6) | 10 433 (21.2) | 0.15 |
| CHA2DS2-VASc score | |||||||
| Mean ± SD | 4.08 ± 1.59 | 3.49 ± 1.37 | 4.86 ± 1.53 | 0.95 | 4.77 ± 1.47 | 4.87 ± 1.53 | 0.07 |
| Median (IQR) | 4 (3–5) | 3 (3–4) | 5 (4–6) | 0.98 | 5 (4–6) | 5 (4–6) | 0.07 |
| HAS-B_ED score | |||||||
| Mean ± SD | 2.20 ± 0.68 | 2.09 ± 0.63 | 2.36 ± 0.71 | 0.41 | 2.30 ± 0.69 | 2.37 ± 0.72 | 0.09 |
| Median (IQR) | 2 (2–3) | 2 (2–2) | 2 (2–3) | 0.38 | 2 (2–3) | 2 (2–3) | 0.10 |
| Concomitant medication within previous 120 d | |||||||
| Nonsteroidal anti-inflammatory drug | 19 273 (15.7) | 15 344 (21.9) | 3929 (7.4) | 0.42 | 304 (8.3) | 3625 (7.3) | 0.03 |
| Acetylsalicylic acid | 2870 (2.3) | 2212 (3.2) | 658 (1.2) | 0.13 | 41 (1.1) | 617 (1.3) | 0.01 |
| Other antiplatelet | 7026 (5.7) | 4459 (6.4) | 2567 (4.8) | 0.07 | 207 (5.6) | 2360 (4.8) | 0.04 |
| Amiodarone | 4048 (3.3) | 598 (0.9) | 3450 (6.5) | 0.30 | 242 (6.6) | 3208 (6.5) | 0.00 |
| Selective serotonin reuptake inhibitor | 14 864 (12.1) | 6189 (8.8) | 8675 (16.4) | 0.23 | 428 (11.6) | 8247 (16.7) | 0.15 |
| Antibiotic** | 17 345 (14.1) | 7384 (10.5) | 9961 (18.8) | 0.24 | 541 (14.7) | 9420 (19.1) | 0.12 |
Note: IQR = interquartile range, NA = not available, SD = standard deviation.
↵* Except where noted otherwise.
↵† Data missing for less than 0.07% of patients.
↵‡ Patients could have more than 1 indication.
↵§ Included International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) codes for dialysis, chronic renal disease, renal cancer and renal surgery.
↵¶ Included ICD-10 codes for cirrhosis, chronic liver disease, liver cancer, hepatitis and liver surgery.
↵** Within 30 days.