Anticoagulant Prescription Patterns in Cirrhosis

Information regarding patient characteristics, including demographics, clinical comorbidities, and medication use was ascertained for each patient during the baseline assessment period. Clinical characteristics included age, sex, calendar year, severity of cirrhosis (defined by prior decompensation events, including ascites, spontaneous bacterial peritonitis, bleeding esophageal varices, hepatic encephalopathy, and hepatorenal syndrome), coagulopathy, thrombocytopenia, prior bleeding events, chronic kidney disease or end‐stage renal disease (CKD/ESRD), CHA₂DS₂VASc score (calculated as 1 point each for congestive heart failure, hypertension, age ≥75 [point doubled], diabetes, prior stroke or transient ischemic attack or thromboembolism [point doubled], vascular disease, age 65–74, female sex), and HAS‐BLED score (calculated as 1 point each for hypertension, abnormal renal function, abnormal liver function or cirrhosis [all patients received this point], prior stroke, prior major bleeding or predisposition to bleeding, a labile international normalized ratio, age >65 years, prior alcohol or drug use history, or use of medications that predispose to bleeding).¹⁴, ²⁶ All comorbidities were identified by ICD‐9 and ICD‐10 codes (see Table S1 for details).
Within the study cohort, the primary outcome was prescription of an OAC (including warfarin and the individual DOACs, apixaban, rivaroxaban, or dabigatran) in the 6 months following (and including) the cohort entry date, between 2012 and 2019.