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Titolo:
Venous thromboembolism following major orthopedic surgery: Review of epidemiology and economics
Autore:
Edelsberg, J; Ollendorf, D; Oster, G;
Indirizzi:
Policy Anal Inc, Brookline, MA 02445 USA Policy Anal Inc Brookline MA USA02445 Anal Inc, Brookline, MA 02445 USA
Titolo Testata:
AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY
fascicolo: 21, volume: 58, anno: 2001, supplemento:, 2
pagine: S4 - S13
SICI:
1079-2082(20011101)58:21<S4:VTFMOS>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
DEEP-VEIN THROMBOSIS; MOLECULAR-WEIGHT HEPARIN; TOTAL HIP-REPLACEMENT; TOTAL KNEE ARTHROPLASTY; RANDOMIZED TRIAL; DOUBLE-BLIND; RISK-FACTORS; PROPHYLAXIS; PREVENTION; MORTALITY;
Keywords:
anticoagulants; arthroplasty; costs; epidemiology; hip fractures; pharmacoeconomics; surgery; thromboembolism; toxicity;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
54
Recensione:
Indirizzi per estratti:
Indirizzo: Oster, G Policy Anal Inc, 4 Davis Court, Brookline, MA 02445 USA Policy Anal Inc 4 Davis Court Brookline MA USA 02445 MA 02445 USA
Citazione:
J. Edelsberg et al., "Venous thromboembolism following major orthopedic surgery: Review of epidemiology and economics", AM J HEAL S, 58(21), 2001, pp. S4-S13

Abstract

The epidemiology and economics of venous thromboembolism (VTE) associated with hip and knee arthroplasty and surgical repair of hip fracture are reviewed. In the 1960s and 1970s, prior to the widespread use of prophylaxis, the risk of VTE following major orthopedic surgery was substantial. The risk of fatal pulmonary embolism (PE) following hip fracture repair may have been ashigh as 7.5%. With improvements in surgical and anesthetic techniques and the use of anticoagulant prophylaxis, these risks have decreased significantly for most patients. Current risks after hip and knee arthroplasty appearto be about 2.5% for deep vein thrombosis, 1% for nonfatal PE, and a few tenths of 1% for fatal PE over a three-month period following surgery. Because of the traumatic nature of the injury, delays in getting to surgery, andtheir more advanced age and poorer overall health, hip fracture patients appear to have a greater risk of postoperative VTE, but data are lacking fora reliable estimate of current risk. The cost of VTE after major orthopedic surgery includes initial therapy (the chief component), followup care, and the expected costs of major hemorrhage (due to anticoagulation), recurrent VTE, and postthrombotic syndrome. The total cost per patient of such careis approximately $11,600. The risk of VTE after surgery to replace hip and knee joints and repair hip fracture is far lower today than in the 1960s and 1970s, but the cost of treating VTE remains high: an estimated $11,600 per patient, including hospitalization costs.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/04/20 alle ore 03:50:56