Background
Methods
Study design and data source
Study population
Patient characteristics
Propensity score matching
Outcomes
Statistical analyses
Results
Pre-index characteristics
Pre-PSM | Post-PSM | |||||
---|---|---|---|---|---|---|
Measure | Dabigatran | Warfarin |
P value | Dabigatran | Warfarin |
P value |
N | 1127 | 3234 | 1110 | 1110 | ||
Age, years | ||||||
Mean ± SD | 75.0 ± 6.9 | 75.3 ± 7.4 | 0.3414 | 75.1 ± 6.9 | 75.0 ± 7.0 | 0.5682 |
Median, [Min – Max] | 75 [42–89] | 76 [40–89] | 75 [42–89] | 75 [46–89] | ||
Male, n (%) | 579 (51.4) | 1663 (51.4) | 0.9783 | 569 (51.3) | 574 (51.7) | 0.8318 |
Race/Ethnicity, n (%) | ||||||
White | 1043 (92.5) | 2908 (89.9) | 0.0093 | 1028 (92.6) | 1000 (90.1) | 0.0345 |
Other | 84 (7.5) | 326 (10.1) | 82 (7.4) | 110 (9.9) | ||
Geographic Region, n (%) | ||||||
Northeast | 27 (2.4) | 82 (2.5) | <0.0001 | 27 (2.4) | 23 (2.1) | 0.4615 |
Midwest | 254 (22.5) | 1004 (31.0) | 254 (22.9) | 254 (22.9) | ||
South | 764 (67.8) | 1868 (57.8) | 747 (67.3) | 768 (69.2) | ||
West | 82 (7.3) | 280 (8.7) | 82 (7.4) | 65 (5.9) | ||
Baseline Deyo-Charlson Comorbidity Index (DCI) score | 2.1 ± 2.1 | 2.9 ± 2.5 | <0.0001 | 2.1 ± 2.1 | 2.1 ± 2.0 | 0.5809 |
Baseline Elixhauser Comorbidity index (ECI) score | 4.4 ± 2.5 | 5.5 ± 2.7 | <0.0001 | 4.4 ± 2.5 | 4.5 ± 2.4 | 0.3789 |
Baseline stroke risk | ||||||
CHADS2 stroke risk score | 2.3 ± 1.2 | 2.6 ± 1.2 | <0.0001 | 2.3 ± 1.2 | 2.3 ± 1.2 | 0.7783 |
CHA2DS2-VASc stroke risk score | 4.0 ± 1.5 | 4.3 ± 1.5 | <0.0001 | 4.0 ± 1.5 | 4.0 ± 1.5 | 0.8061 |
Baseline bleeding risk | 0.1780 | |||||
HEMORR2HAGES score | 2.4 ± 1.5 | 2.9 ± 1.7 | <0.0001 | 2.4 ± 1.5 | 2.4 ± 1.4 | |
Time from first AF to index (days) | 20 ± 22 | 19 ± 22 | 0.0282 | 20 ± 22 | 18 ± 22 | 0.0559 |
Duration of follow-up (days) | ||||||
Mean ± SD | 346 ± 62 | 339 ± 74 | 0.0010 | 346 ± 62 | 343 ± 68 | 0.3329 |
Median [Range] | 365 [42–365] | 365 [9–365] | 365 [42–365] | 365 [11–365] | ||
Total HCRU pre-index, mean visits per patient [SD] | ||||||
Hospitalization | 0.8 [0.7] | 1.1 [0.9] | <.0001 | 0.8 [0.7] | 0.9 [0.7] | 0.0183 |
ER visit | 0.7 [1.2] | 0.8 [1.5] | 0.3055 | 0.7 [1.3] | 0.7 [1.1] | 0.0603 |
Physician office visit | 12.4 [9.6] | 12.3 [10.3] | 0.7100 | 12.4 [9.7] | 11.6 [9.2] | 0.0293 |
Outpatient visit | 5.7 [6.8] | 7.3 [14.0] | <.0001 | 5.7 [6.8] | 6.1 [11.6] | 0.3758 |
Healthcare resource utilization
Outcome | Dabigatran | Warfarin |
P valueb
|
---|---|---|---|
N | 1110 | 1110 | |
Hospitalization | |||
Number of patients hospitalized, n (%) | 284 (25.6) | 332 (29.9) | |
All cause hospitalizations, n | 381 | 475 | |
Mean PPPYa [SD] (95% CI) | 0.92 [3.10] (0.74, 1.11) | 1.13 [2.90] (0.96, 1.30) | 0.0124 |
Median PPPYa (25p, 75p) | 0.0 (0.0, 1.0) | 0.0 (0.0, 1.0) | |
ER visits | |||
Number of patients with an ER visit, n (%) | 309 (27.8) | 378 (34.1) | |
All cause ER visits, n | 563 | 780 | |
Mean PPPYa [SD] (95% CI) | 1.32 [4.04] (1.08, 1.56) | 1.56 [3.74] (1.34, 1.78) | 0.0011 |
Median PPPYa (25p, 75p) | 0.0 (0.0, 1.0) | 0.0 (0.0, 1.6) | |
Physician office visits | |||
Number of patients with a physician office visit, n (%) | 1068 (96.2) | 1084 (97.7) | |
All cause physician office visits (n) | 11,571 | 18,765 | |
Mean PPPYa [SD] (95% CI) | 21.43 [17.98] (20.37, 22.49) | 29.41 [18.68] (28.31, 30.51) | < 0.0001 |
Median PPPYa (25p, 75p) | 17.0 (10.2, 27.3) | 26.4 (16.5, 39.0) | |
Outpatient visits | |||
Number of patients with an outpatient visit, n (%) | 945 (85.1) | 1040 (93.7) | |
All cause outpatient visits (n) | 5563 | 13,029 | |
Mean PPPYa [SD] (95% CI) | 10.86 [15.44] (9.95, 11.77) | 22.02 [23.37] (20.64, 23.39) | < 0.0001 |
Median PPPYa (25p, 75p) | 6.6 (3.0, 12.4) | 16.6 (6.7, 29.0) |
Healthcare costs
Outcome | Dabigatran | Warfarin |
P valueb
| |
---|---|---|---|---|
Total Cost, mean (95% CI) | ||||
Unadjusted GLM Mean | $2362 ($2213, $2521) | $2204 ($2065, $2352) | 0.1398 | |
Adjusted GLM Meand
| $2381 ($2106, $2700) | $2183 ($1929, $2481) | 0.0967 | |
Total Pharmacy Cost, mean (95% CI) | ||||
Unadjusted GLM Mean | $509 ($488, $531) | $251 ($240, $262) | <.0001 | |
Adjusted GLM Meand
| $510 ($470, $555) | $250 ($230, $273) | <.0001 | |
Total Medical Cost, mean (95% CI) | ||||
Unadjusted GLM Mean | $1903 ($1757, $2060) | $1973 ($1823, $2135) | 0.5276 | |
Adjusted GLM Meand
| $1912 ($1646, $2231) | $1956 ($1683, $2286) | 0.5500 | |
Hospital-related All-Cause Medical Cost, mean (95% CI) | ||||
Unadjusted GLM Mean | $1534 ($1283, $1833) | $1596 ($1338, $1903) | 0.7552 | |
Adjusted GLM Meand
| $1094 ($821, $1480) | $1137 ($851, $1539) | 0.6607 | |
ER related All-Cause Medical Cost, mean (95% CI) | ||||
Unadjusted GLM Mean | $73 ($65, $83) | $82 ($73, $92) | 0.2036 | |
Adjusted GLM Meand
| $72 ($58, $91) | $83 ($66, $104) | 0.0967 | |
Physician office visits related All-Cause Medical Cost, mean (95% CI) | ||||
Unadjusted GLM Mean | $285 ($269, $303) | $287 ($270, $305) | 0.8929 | |
Adjusted GLM Meand
| $282 ($252, $317) | $289 ($258, $326) | 0.3792 | |
Outpatient visits related All-Cause Medical Cost, mean (95% CI) | ||||
Unadjusted GLM Mean | $399 ($361, $441) | $360 ($325, $398) | 0.1554 | |
Adjusted GLM Meand
| $396 ($327, $482) | $362 ($300, $445) | 0.3120 |