Cost-Effective Prophylaxis Against Venous Thromboembolism After Total Joint Arthroplasty: Warfarin Versus Aspirin

被引：42

作者：

Tabatabaee, Reza Mostafavi ^{[1
]}

Rasouli, Mohammad R. ^{[1
]}

Maltenfort, Mitchell G. ^{[1
]}

Parvizi, Javad ^{[1
]}

机构：

[1] Thomas Jefferson Univ, Rothman Inst Orthopaed, Philadelphia, PA 19107 USA

来源：

JOURNAL OF ARTHROPLASTY | 2015年 / 30卷 / 02期

关键词：

aspirin; warafarin; venous thromboembolism; total joint arthroplasty; cost-effectiveness analysis; TOTAL HIP-REPLACEMENT; MOLECULAR-WEIGHT HEPARIN; ORTHOPEDIC-SURGERY; KNEE REPLACEMENT; ECONOMIC BURDEN; THROMBOPROPHYLAXIS; ENOXAPARIN; PREVENTION; THROMBOSIS; ANTICOAGULATION;

D O I：

10.1016/j.arth.2014.08.018

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Although recent guidelines suggest aspirin for venous thromboembolism (VTE) prophylaxis in low risk patients following total hip arthroplasty (THA) and total knee arthroplasty (TKA), there are no cost-effectiveness studies comparing aspirin and warfarin. In a Markov cohort cost-effectiveness analysis, we found that aspirin cost less and saved more quality-adjusted life-years (QALYs) than warfarin in all age groups. Cost per QALY gained by aspirin was $24,506.20 at age of 55 and $47,148.10 at the age of 85 following THA and $15,117.20 and $24,458.10 after TKA, which were greater than warfarin. In patients undergoing THA/TKA without prior VTE, aspirin is more cost-effective prophylactic agent than warfarin. Warfarin might be a better prophylaxis in TKA patients with high probability of VTE and very low probability of bleeding. (C) 2014 Elsevier Inc. All rights reserved.

引用

页码：159 / 164

页数：6

共 43 条

[1]

[Anonymous], 2011, PREV VEN THROMB DIS

[2]

[Anonymous], 2007, VEN THROMB RED RISK

[3]

Arias Elizabeth, 2012, Natl Vital Stat Rep, V61, P1

[4] Cost Implications of Formulary Decisions on Oral Anticoagulants in Nonvalvular Atrial Fibrillation [J].

Biskupiak, Joseph ;

Ghate, Sameer R. ;

Jiao, Tianze ;

Brixner, Diana .

JOURNAL OF MANAGED CARE PHARMACY, 2013, 19 (09) :789-798

[5] Venous Thromboembolism Prophylaxis After Major Orthopaedic Surgery: A Pooled Analysis of Randomized Controlled Trials [J].

Brown, Greg A. .

JOURNAL OF ARTHROPLASTY, 2009, 24 (06) :77-83

[6]

Bullano Michael F, 2005, J Manag Care Pharm, V11, P663

[7] Economic burden of long-term complications of deep vein thrombosis after total hip replacement surgery in the United States [J].

Caprini, JA ;

Botteman, MF ;

Stephens, JM ;

Nadipelli, V ;

Ewing, MM ;

Brandt, S ;

Pashos, CL ;

Cohen, AT .

VALUE IN HEALTH, 2003, 6 (01) :59-74

[8] Oral direct thrombin inhibitor ximelagatran compared with warfarin for the prevention of venous thromboembolism after total knee arthroplasty [J].

Colwell, CW ;

Berkowitz, SD ;

Lieberman, JR ;

Comp, PC ;

Ginsberg, JS ;

Paiement, G ;

McElhattan, J ;

Roth, AW ;

Francis, CW .

JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2005, 87A (10) :2169-2177

[9] Economic Burden of Venous Thromboembolism in Hospitalized Patients [J].

Dobesh, Paul P. .

PHARMACOTHERAPY, 2009, 29 (08) :943-953

[10] Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty [J].

Eriksson, Bengt I. ;

Borris, Lars C. ;

Friedman, Richard J. ;

Haas, Sylvia ;

Huisman, Menno V. ;

Kakkar, Ajay K. ;

Bandel, Tiemo J. ;

Beckmann, Horst ;

Muehlhofer, Eva ;

Misselwitz, Frank ;

Geerts, William .

NEW ENGLAND JOURNAL OF MEDICINE, 2008, 358 (26) :2765-2775

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