BACKGROUND: International recommendations suggest considering home treatment or early hospital discharge in low risk mortality @entity1151 ( @entity1151 ). Direct oral anticoagulants (DOACs) may offer several advantages in the management of acute @entity1151 . The aim of the present study was to focus on trends in length of hospital stay (LOS) over the years and on the burden of DOACs on this endpoint in @entity1 suffering from acute @entity1151 . MATERIALS AND METHODS: We retrospectively analyzed data of @entity1 discharged from five hospitals of the Florence district, Italy, searching for International Classification of Disease 9th revision Clinical Modification (ICD-9CM) codes 415.11 or 415.19 in hospital discharge schedule in the years 2010, 2012 and from 2014 January, 1st to 2015 August 31st. @entity1 who died during hospital stay were excluded from analysis on LOS. In the survivors from one of the five hospitals, we also focused on anticoagulants prescribed at hospital discharge according to early mortality risk assessment by using the new 2014 European Society of Cardiology (ESC) prognostic model. RESULTS: Over the years, @entity1 discharged for @entity1151 have reduced in number. Despite a trend in reduction, mean and median LOS have not significantly decreased over the years. A very small percentage (3%) of @entity1 received an ultra-early discharge from hospitals within 48 hours from admission, whereas the percentage of @entity1 who were discharged within 6 days increased from 26.6% to 31.5%. In 2014 and 2015, 36.7% of @entity1 with diagnosis of acute @entity1151 were discharged on low molecular weight heparins or fondaparinux, 32.5% of @entity1 were discharged on @entity2067 antagonists and 30.4% of @entity1 on DOACs. DOACs prescription increased from 23.2% in 2014 to 40.1% in 2015. Mean and median LOS in @entity1 on DOACs were significantly lower than in @entity1 on other anticoagulant treatments. DOACs were prescribed in 40% of high risk, 68.1% of intermediate-high risk, 40.4% of intermediate-low risk and finally in 83.3% of low risk @entity1 ; 28% of @entity1 received DOACs within 48-hours from diagnosis and 64% received DOACs within 96 hours from diagnosis. Median timing for starting DOACs from diagnosis was 4 days (IQR 2-5). In @entity1 receiving DOACs, median LOS was 6 days (IQR 5-7) in low risk @entity1 compared with 8 days (IQR 7-9) in non low (intermediate/high) risk @entity1 . Median LOS after DOACs prescription was 5 days (IQR 1-6). CONCLUSION: In Florence district, early discharges and LOS in @entity1 with acute @entity1151 have not significantly changed over the years. Due to a significant LOS reduction in @entity1 , prescribing DOACs hospital costs could be dramatically saved. Further prospective investigations are absolutely warranted to clarify these points.

Trends in length of hospital stay in XXXX over the years. What is changing in the era of direct oral anticoagulants?

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity2067 :: ('MESH:D014812', 'Chemical') :: ['vitamin K'] @entity1151 :: ('MESH:D011655', 'Disease') :: ['PE', 'acute pulmonary embolism']
@entity1151 :: (MESH:D011655,Disease) :: ['acute pulmonary embolism']
