| アブストラクト | Objective The number of patients using direct oral anticoagulants (DOACs) has recently increased. However, the association between DOAC use and bronchoscopy (BS) safety has not been elucidated. This study examined the association between BS and DOAC use and safety. Methods Using data from the Japanese Diagnosis Procedure Combination database from July 1, 2010, to March 31, 2022, patients taking DOACs who underwent BS (n=603, DOAC group) and those who did not (n=187,827, non-DOAC group) were identified. Then, 1:4 matched-pair cohort analyses were performed based on the institution, sex, age, and treatment year. The primary outcome was all-cause in-hospital mortality. The secondary outcomes were 28-day mortality, mechanical ventilation use, pneumothorax, bleeding, and thromboembolism after BS. Results A total of 603 and 2,320 patients taking and not taking DOAC, respectively, were identified via matching. The all-cause in-hospital mortality rates in the DOAC and non-DOAC groups were 12.1% and 5.8%, respectively. In a multivariable logistic regression analysis, the DOAC group had a significantly higher all-cause in-hospital mortality rate than the non-DOAC group (odds ratio = 2.84, 95% confidence interval = 1.77-4.55). Secondary and composite outcomes (mechanical ventilation, pneumothorax, bleeding, and thromboembolism after BS combined) were more frequent in the DOAC group than in the non-DOAC group. Conclusion DOACs were associated with mortality and complications in patients undergoing BS. Further studies comparing BS outcomes between patients with and without DOAC treatment are necessary. |
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| ジャーナル名 | Internal medicine (Tokyo, Japan) |
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| Pubmed追加日 | 2025/5/8 |
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| 投稿者 | Awano, Nobuyasu; Jo, Taisuke; Izumo, Takehiro; Urushiyama, Hirokazu; Matsui, Hiroki; Fushimi, Kiyohide; Watanabe, Hideaki; Yasunaga, Hideo |
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| 組織名 | Department of Respiratory Medicine, Japanese Red Cross Medical Center, Japan.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Japan.;Department of Respiratory Medicine, Graduate School of Medicine, The University;of Tokyo, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Japan.;Department of Health Policy and Informatics, Institute of Science Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/40335303/ |
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