Liver injury from direct oral anticoagulants

Table 1 The baseline patient parameters, n (%)

Variables	Number of patients (n = 27)
Age (± SD), yr	72.7 (± 11.4)
Sex	Females, 13 (48.1)
	Males, 13 (48.1)
	Not mentioned, 1 (3.7)
Country of origin	Switzerland, 12 (44.4)
	Italy, 4 (14.8)
	United States of America, 4 (14.8)
	France, 3 (11.1)
	Australia, 1 (3.7)
	Canada, 1 (3.7)
	Ireland, 1 (3.7)
	Spain, 1 (3.7)
Clinical presentation	Jaundice, 15 (55.6)
	Malaise, 9 (33.3)
	Vomiting, 9 (33.3)
	Abdominal pain, 3 (11.1)
	Itching, 3 (11.1)
	Anorexia, 2 (7.4)
	Fatigue, 2 (7.4)
	Dyspepsia, 1 (3.7)
	Breathlessness, 1 (3.7)
	Pruritus, 1 (3.7)
	Weight loss, 1 (3.7)
Comorbidities	Hypertension, 6 (22.2)
	Diabetes, 3 (11.1)
	Coronary artery disease, 3 (11.1)
	Others, 6 (22.2)
Other drugs causing liver injury	None, 11 (40.7)
	Statins, 4 (14.8)
	Not mentioned, 12 (44.4)
DOACs implicated	Rivaroxaban, 20 (74.1)
	Apixaban, 4 (14.8)
	Dabigatran, 3 (11.1)
Indications of DOACs	Atrial fibrillation, 13 (48.1)
	Pulmonary embolism, 2 (7.4)
	Transient ischemic attack, 1 (3.7)
	Anti-phospholipid antibody syndrome, 1 (3.7)
	Deep vein thrombosis, 1 (3.7)
	Major lower limb surgery, 1 (3.7)
	Sinus node dysfunction, 1 (3.7)
	Accidental, 1 (3.7)
Time to presentation after initiation of DOACs (d)	40.6 ± 42.8
Need for organ support	Renal replacement therapy, 1 (3.7)
	Vasopressors, 1 (3.7)
	Invasive mechanical ventilation, 1 (3.7)
Need for specific antidote	Idarucizumab, 1 (3.7)
Days in hospital (d)	8 ± 9.3
Days in ICU (d)	7 ± 12.1
Outcome	Alive, 26 (96.3)
	Death, 1 (3.7)

SD: Standard deviation; DOAC: Direct-acting oral anticoagulants; ICU: Intensive care unit.

Table 2 Liver function test parameters

Parameter	Mean	Standard deviation	Range
SGOT, at presentation (units/L)	575.5	672.2	90-2304
SGPT, at presentation (units/L)	800.2	1159.6	90-4000
Total bilirubin, at presentation (mg/dl)	6.3	6	0.64-21.8
Direct bilirubin, at presentation (mg/dl)	4.8	4.9	0.3-10.3
Alkaline phosphatase, at presentation (units/L)	269.2	279.5	60-1039

SGOT: Serum glutamic oxaloacetic transaminase; SGPT: Serum glutamic pyruvic transaminase.