Use patterns of low-molecular weight heparin and the impact on length of stay in patients hospitalized for atrial fibrillation

Background Low-molecular weight heparin, although unproven as a protective anticoagulant in atrial fibrillation, is not uncommonly used in this clinical setting. This investigation sought to assess the prevalence of its use for atrial fibrillation and its impact on length of hospital stay. Methods A retrospective analysis of patients admitted to the cardiology service at a university hospital with the primary diagnosis of atrial fibrillation was conducted for a 6-month interval in 3 consecutive years. Baseline demographic and clinical information, anticoagulation status, and length of hospital stay were compared. Results A total of 213 patients were identified and divided into 2 groups (before and after low-molecular weight heparin availability). Low-molecular weight heparin use increased with time (0% in 1997, 16.9% in 1998, 24.1% in 1999) and was associated with a significant reduction in length of hospital stay, from 3.3 ± 2.8 days to 2.4 ± 2.1 days (P = .03), and a trend toward a decreased international normalized ratio. Conclusions This investigation noted the increasing trend toward the use of low-molecular weight heparin as a protective anticoagulant for atrial fibrillation, despite the lack of controlled data about its efficacy. The observed reduction in length of hospital stay is implicated as a potential reason for the use of low-molecular weight heparin. (Am Heart J 2003;145:665-9.)