Economic burden of long-term complications of deep vein thrombosis after total hip replacement surgery in the United States
Economic burden of long-term complications of deep vein thrombosis after total hip replacement surgery in the United States
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DOI：
10.1046/j.1524-4733.2003.00204.x
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发表时间：
2003-01-01
期刊：
影响因子：
4.5
通讯作者：
Cohen, AT
中科院分区：
文献类型：
--
作者：
Caprini, JA;Botteman, MF;Cohen, AT
背景资料：估计原发性深静脉血栓形成（DVT）的长期并发症（包括血栓后综合征（PTS）和复发性静脉血栓栓塞（VTE））的成本可能与资源分配决策相关。目的：本研究的目的是提供美国的成本估计的长期并发症的原发性DVT，发生在约5%至20%（有足够的血栓预防）和50%（在没有血栓预防）的全髋关节置换手术（THRS）。方法：一个基于文献的模型被用来预测DVT的THRS后的长期并发症成本。该模型使用已发表的PTS和复发性VTE的发病率和预后估计值模拟DVT并发症的自然史。结果：每种并发症的年人均成本分别为：轻中度PTS第一年839美元，以后各年341美元，重度PTS第一年3817美元，以后各年1677美元，DVT 3798美元，重度PTS第一年3817美元，以后各年1677美元。肺栓塞6604美元DVT并发症的平均折扣终身成本估计为$3069（95%区间$2091-$4279）。结论：原发性DVT的长期并发症是一个重大的经济负担。可以说，预防深静脉血栓形成可以大幅减少长期深静脉血栓形成并发症的发生。
Background: Estimates of the cost of long-term complications of a primary deep vein thrombosis (DVT), including the post-thrombotic syndrome (PTS) and recurrent venous thromboembolism (VTE), may be relevant for resource allocation decisions. Objective: The objective of this study was to provide US cost estimates of the long-term complications of a primary DVT, which occurs in approximately 5% to 20% (with adequate thromboprophylaxis) and 50% (in the absence of thromboprophylaxis) of total hip replacement surgeries (THRS).Methods: A literature-based model was used to project the excess long-term complication costs of DVT following THRS. The model simulated the natural history of DVT complications using published estimates of the incidence and prognosis of PTS and recurrent VTE. Each complication was assigned a cost obtained by multiplying the amount of resources used in its management by the unit price of these resources.Results: The annual per-patient cost of each complication was as follows: mild-to-moderate PTS, $839 in the first year and $341 in subsequent years; severe PTS, $3817 in the first year and $1677 in subsequent years; DVT, $3798; and pulmonary embolism, $6604. The average discounted lifetime cost of DVT complications was estimated to be $3069 (95% interval $2091-$4279).Conclusions: The long-term complications of a primary DVT represent a significant economic burden. Preventing a DVT could arguably lead to substantial savings in long-term DVT complications.