146 Patients With Hospital Delirium Are Most Often Identified in the Emergency Department and Experience Longer Hospital Stays

Abstract

gastrointestinal bleeding events was similar for VKA and DOACs (25 each); VKA had a higher rate of intracranial bleeding (16/27, 59%) vs DOAC (11/27, 41%). All remaining MBE occurred in VKA patients. There were no deaths directly attributable to any MBE in either the DOAC or VKA group. A substantial number of patients with MBE were transferred for urgent neurosurgical evaluation (26/27 intracranial bleeds and the 1 spinal epidural hematoma). 52/55 (94%) of the remaining MBE patients were admitted to a critical care area. The mean INR of the VKA patients was 4.99 (range, 2.3-10). Anti-Xa activity was not routinely assessed in the patients on DOACs. During the period reviewed, there were an average of 2,351 patients/month being managed on VKA and 3,155 patients/month being managed on DOACs.Conclusion: Major bleeding events occurred in patients on both VKA and DOACs. While similar rates of MBE involving the gastrointestinal tract were seen, in all other MBE there were a greater number of bleeds involving VKA. Though there was substantial morbidity, there were no deaths reported in either group. Further study is needed to determine the safety risk of VKA vs DOAC's in our population.