在肩膀手术中进行静脉血栓栓塞预防:一个平衡性成本效益研究
Brandon J Martinazzi1, Christopher M Stauch2, Peter F Monahan3
1Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA.
Journal of shoulder and elbow surgery
|November 9, 2023
概括
阿司匹林和埃诺沙巴林在肩部手术后预防静脉血栓塞栓症 (VTE) 是具有成本效益的,阿司匹林在所有手术中都是具有成本效益的,而埃诺沙巴林在特定手术中是具有成本效益的. 对于最佳的VTE预防策略,需要进一步的研究.
科学领域:
- 整形外科手术 整形外科手术
- 药物经济学 药物经济学
- 血管医学 血管医学
背景情况:
- 静脉血栓栓塞 (VTE) 是骨科肩部手术后的一个重大风险.
- 在这种患者群体中,VTE预防的成本效益研究有限.
研究的目的:
- 确定阿司匹林和埃诺沙巴林在接受肩部手术的患者中预防静脉瘤的平衡性成本效益.
主要方法:
- 通过使用药品零售价格和VTE治疗的机构成本进行了平衡成本分析.
- 从TrinetX国家数据库中获得了各种肩部手术的VTE率.
- 计算绝对风险降低 (ARR) 来确定需要治疗的患者数量以确定成本效益.
主要成果:
- 对阿司匹林 (成本: 1.18 美元) 和埃诺沙巴林 (成本: 125.37 美元) 进行了分析,对比VTE治疗成本为 9407.00 美元.
- 在所有肩膀手术中,阿司匹林的ARR为0.01%.
- 埃诺沙巴林在肩膀关节整形术和半关节整形术中以1.33%的ARR破解,但在当前价格下,对关节镜旋转手套修复而言并非如此.
结论:
- 在特定的VTE率降低下,阿司匹林和埃诺沙巴林在肩关节整形和肩膀整形中实现了VTE预防的成本效益.
- 对于关节镜旋转袖口修复,只有阿司匹林在当前的市场价格下证明了成本效益.
- 最佳的VTE预防策略需要进一步研究,特别是对于低风险手术中埃诺沙巴林的成本效益.
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