延长时间静脉血栓栓塞的成本效益 高风险泌尿外科瘤学手术患者的预防
Janet E Baack Kukreja1,2, Helen R Levey1, Ahmed Ghazi1
1Department of Urology, University of Rochester School of Medicine and Dentistry, Rochester, New York.
Urology practice
|August 18, 2023
概括
大型泌尿外科手术后的长期预防可显著降低高风险患者的静脉血栓栓塞 (VTE) 风险. 与其他方法相比,这种策略不仅有效,而且节省了成本.
科学领域:
- 泌尿外科瘤学 泌尿外科瘤学
- 血管外科 血管外科
- 药物经济学 药物经济学
背景情况:
- 大型泌尿瘤手术具有术后静脉血栓栓塞 (VTE) 的高风险,导致显著的发病率,死亡率和成本.
- 对高风险患者来说,评估长期预防的成本效益至关重要.
研究的目的:
- 为了确定在医院和低分子量肝素延长时间预防VTE预防的增量成本效益.
- 为了比较高风险患者的四种预防策略的VTE发病率,成本和结果.
主要方法:
- 一个决策分析模型被用来比较基于协议遵守和延长时间预防的四种预防策略.
- 该研究包括707名接受重大泌尿瘤手术的患者,其中309人被确定为使用卡普里尼评分的高风险患者.
- 数据是在2011年6月至2014年3月期间收集的.
主要成果:
- 涉及每条协议住院预防和延长时间预防的策略在VTE预防概率超过80%时占主导地位.
- 比较两种最接近的策略 (第一组与第二组),观察到每名患者的总体成本节省为1390美元.
- 在非扩展预防组中,VTE发病率对有效性产生了最大的影响.
结论:
- 住院和长期预防在接受重大泌尿瘤手术的高风险患者中有效预防VTE.
- 与替代方法相比,这种预防策略可以节省成本.
- 优化预防方案可以提高VTE预防和降低医疗保健成本.
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