The cost of treating pulmonary embolisms following surgery for gynecological malignancies

Abstract

8250 Background: Pulmonary embolism is one of the most common causes of postoperative morbidity and mortality in women treated for gynecologic malignancy. This study evaluates the cost of three common treatment options following the diagnosis of postoperative pulmonary embolism. Methods: Twenty patients were identified at our institution over a two year period that were diagnosed with a postoperative pulmonary embolism. Three treatment arms were evaluated. Two patients were treated with IVC Filter only, eight patients were treated with an IVC filter and anticoagulation consisting of lovenox and/or coumadin, and twelve patients were treated with anticoagulation therapy only. The cost of the hospital stay was factored into the total cost of treatment. The cost of each treatment option was obtained from the billing department at our institution. Results: In the first treatment arm involving IVC filter placement only, the average hospital stay was 3.5 days with an average cost of inpatient and outpatient treatment of $7,897.50. In the second treatment arm consisting of anticoagulation therapy and IVC filter placement, the average hospital stay was 6.3 days with an average overall cost of treatment totaling $9,721.35. Anticoagulation therapy alone resulted in an average hospital stay of 14.8 days, with a cost a treatment averaging $21,905.90. The length of hospital stay mentioned above reflects the hospital days after the PE diagnosis. The average cost for each treatment arm reflects both the inpatient and outpatient treatment costs of the parameters specified following PE diagnosis. Conclusion: This study determines the average cost of treating a pulmonary embolism in the post-operative period using three separate treatment options. The increased cost of anticoagulation therapy alone may result from continued inpatient management and the need for outpatient lab testing. Randomized studies are warranted to evaluate the cost/benefit analysis, safety, and outcome with a pre-operative anti-coagulation preventative management algorithm. No significant financial relationships to disclose.