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Long-term cost-effectiveness of low molecular weight heparin versus unfractionated heparin for the prophylaxis of venous thromboembolism in elective hip replacement.
Marchetti, M; Liberato, N L; Ruperto, N; Barosi, G.
Afiliación
  • Marchetti M; Laboratory of Medical Informatics, IRCCS Policlinico S. Matteo, Pavia, Italy.
Haematologica ; 84(8): 730-7, 1999 Aug.
Article en En | MEDLINE | ID: mdl-10458700
BACKGROUND AND OBJECTIVE: Either low molecular weight heparin (LMWH) or unfractionated heparin (UH) may be used for the prophylaxis of post-operative venous thromboembolic disease (VTD) in elective hip replacement. This study was aimed at assessing the cost-effectiveness of LMWH over UH from the society perspective, which considers all the outcomes occurring in the life-long time horizon. DESIGN AND METHODS: A decision tree modeled the clinical outcomes and resources used in consequence of restricted (2 weeks) and extended (4 weeks) prophylaxis of VTD with LMWH or UH. RESULTS: In the studied population, that of 67 year-old patients, restricted prophylaxis with LMWH saved 25 quality-adjusted days and $75 over UH. Extended prophylaxis provided a small additional benefit with additional cost savings. The incremental outcomes of the model proved independent of most parameters. INTERPRETATION AND CONCLUSIONS: We conclude that LMWH has considerable advantages over UH in the prophylaxis of VTD following elective hip replacement, and should be recommended in clinical practice.
Asunto(s)
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Heparina / Heparina de Bajo-Peso-Molecular / Artroplastia de Reemplazo de Cadera / Trombosis de la Vena / Anticoagulantes Tipo de estudio: Health_economic_evaluation / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Haematologica Año: 1999 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Heparina / Heparina de Bajo-Peso-Molecular / Artroplastia de Reemplazo de Cadera / Trombosis de la Vena / Anticoagulantes Tipo de estudio: Health_economic_evaluation / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Haematologica Año: 1999 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia