Use of health resources and costs associated with the diagnosis and treatment of each episode of deep vein thrombosis and bleeding in patients undergoing orthopaedic surgery for hip or knee

Abstract

ObjectiveTo determine the use of healthcare resources and costs associated with the diagnosis and treatment of thrombosis and bleeding patients who have undergone elective hip or knee replacement surgery, in routine clinical practice conditions. Patients and methodsThis multicentre observational and retrospective study extracted data from the medical records of three Spanish public hospitals (2010). Patients ≥40 years who had received prophylaxis-anticoagulation were included. They were randomised into three groups: (a) control (no hospital complications), (b) bleeding, and (c) thrombosis. General variables, use of resources and costs were analysed. Statistical analysis: logistic regression and ANCOVA for model correction (P<.05) was included. ResultsA total of 141 patients (control: 60; bleeding: 60; and thrombosis: 21), with a mean age 68.7 (SD: 10.4) years, and 68.1% females were identified. Hip arthroplasty was more frequent (71.6%). The bleeding risk was associated with age (OR=1.1) and thrombosis with COPD (OR=1.8); P<.05). The average length of stay for the thrombosis, bleeding and control groups was 13.9, 11.5 and 7.4 days, respectively; P<.001). The total costs for each group were €10,484.3; €8766.4 and €6496.1 respectively; P<.05. All grouped results were comparable between them according to the hospital analysed and the type of replacement. ConclusionsCosts were higher for thrombosis and bleeding patients, respectively. Costs were associated with length of stay and hospital-acquired infections.