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Related Experiment Videos

Clinical and economic outcomes with appropriate or partial prophylaxis.

A N Amin1, J Lin, B H Johnson

  • 1University of California, Irvine, Orange, CA92868, USA. anamin@uci.edu

Thrombosis Research
|November 26, 2009
PubMed
Summary

Appropriate venous thromboembolism (VTE) prophylaxis, as recommended by guidelines, significantly reduces pulmonary embolism and bleeding events. This adherence to VTE prevention strategies also proves cost-effective for healthcare systems.

Related Experiment Videos

Area of Science:

  • Medical research
  • Clinical pharmacology
  • Health economics

Background:

  • Evidence-based guidelines exist for venous thromboembolism (VTE) prevention.
  • Prophylaxis for VTE is frequently prescribed inappropriately.
  • This study evaluates appropriate versus partial VTE prophylaxis.

Purpose of the Study:

  • Compare the efficacy, safety, and cost of appropriate (ACCP-recommended) VTE prophylaxis versus partial prophylaxis.
  • Assess outcomes in high-risk VTE patients receiving enoxaparin or unfractionated heparin.

Main Methods:

  • Retrospective analysis of the MarketScan Hospital Drug Database (2004-2007).
  • Included were medical and surgical patients aged >=40 years with VTE risk and >=6-day hospital stay.
  • Compared hospital-acquired VTE, adverse events, and costs between appropriate and partial prophylaxis groups.

Main Results:

  • Appropriate prophylaxis was given to 24.5% of 21,001 patients.
  • Appropriate prophylaxis showed lower incidences of hospital-acquired pulmonary embolism (0.5% vs 0.9%) and bleeding events (5.1% vs 10.7%).
  • Appropriate prophylaxis resulted in significantly lower total costs per discharge ($17,386 vs $23,823).

Conclusions:

  • ACCP-guideline recommended VTE prophylaxis reduces hospital-acquired pulmonary embolism and bleeding.
  • Appropriate VTE prophylaxis is cost-saving when considering total direct medical costs.
  • Improving adherence to VTE prophylaxis guidelines can decrease the clinical and economic burden of VTE.