Biomaterial Database

Deep venous thrombosis prophylaxis in trauma: cost analysis. 2000

W E Wade, and M A Chisholm

College of Pharmacy, University of Georgia, Athens 30602, USA. BWADE@rx.uga.edu

Deep vein thrombosis and pulmonary embolism are major risks in patients experiencing major trauma. Currently, the American College of Chest Physicians recommends low molecular weight heparin as prophylaxis in trauma patients with identifiable risk factors in the absence of contraindications. Enoxaparin is the only low molecular weight heparin available in the US that has been evaluated to date in this indication. The purpose of this study was to perform incremental cost-effectiveness ratio calculations for enoxaparin versus no prophylaxis as thromboembolic prophylaxis in trauma patients. These calculations demonstrate that a cost of $279.43 would be incurred for each thromboembolic event avoided if enoxaparin 30 mg every 12 h were routinely used as prophylaxis in this population, compared with no prophylaxis. Sensitivity analyses demonstrate that if the incidence of proximal vein thrombosis in patients prophylaxed with enoxaparin approached 1.8%, if the actual rate of these thrombi exceeded 19.4% in untreated patients, or if the cost of the drug was decreased to $15.25 per dose, a cost saving would be experienced in routine prophylaxis with this agent.

UI	MeSH Term	Description	Entries
D003365	Costs and Cost Analysis	Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.	Affordability,Analysis, Cost,Cost,Cost Analysis,Cost Comparison,Cost Measures,Cost-Minimization Analysis,Costs and Cost Analyses,Costs, Cost Analysis,Pricing,Affordabilities,Analyses, Cost,Analyses, Cost-Minimization,Analysis, Cost-Minimization,Comparison, Cost,Comparisons, Cost,Cost Analyses,Cost Comparisons,Cost Measure,Cost Minimization Analysis,Cost, Cost Analysis,Cost-Minimization Analyses,Costs,Measure, Cost,Measures, Cost
D006495	Heparin, Low-Molecular-Weight	Heparin fractions with a molecular weight usually between 4000 and 6000 kD. These low-molecular-weight fractions are effective antithrombotic agents. Their administration reduces the risk of hemorrhage, they have a longer half-life, and their platelet interactions are reduced in comparison to unfractionated heparin. They also provide an effective prophylaxis against postoperative major pulmonary embolism.	LMWH,Low-Molecular-Weight Heparin,Low Molecular Weight Heparin,Heparin, Low Molecular Weight
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000075202	Contraindications	A condition or factor associated with a recipient that makes the use of a drug, procedure, or physical agent improper or inadvisable. Contraindications may be absolute (life threatening) or relative (higher risk of complications in which benefits may outweigh risks).	Contraindications, Physical Agent,Medical Contraindications,Agent Contraindication, Physical,Agent Contraindications, Physical,Contraindication,Contraindication, Medical,Contraindication, Physical Agent,Contraindications, Medical,Medical Contraindication,Physical Agent Contraindication,Physical Agent Contraindications
D014947	Wounds and Injuries	Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity.	Injuries,Physical Trauma,Trauma,Injuries and Wounds,Injuries, Wounds,Research-Related Injuries,Wounds,Wounds and Injury,Wounds, Injury,Injury,Injury and Wounds,Injury, Research-Related,Physical Traumas,Research Related Injuries,Research-Related Injury,Trauma, Physical,Traumas,Wound
D016032	Randomized Controlled Trials as Topic	Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.	Clinical Trials, Randomized,Controlled Clinical Trials, Randomized,Trials, Randomized Clinical
D016239	MEDLINE	The premier bibliographic database of the NATIONAL LIBRARY OF MEDICINE. MEDLINE® (MEDLARS Online) is the primary subset of PUBMED and can be searched on NLM's Web site in PubMed or the NLM Gateway. MEDLINE references are indexed with MEDICAL SUBJECT HEADINGS (MeSH).	Index Medicus
D020246	Venous Thrombosis	The formation or presence of a blood clot (THROMBUS) within a vein.	Deep Vein Thrombosis,Phlebothrombosis,Thrombosis, Deep Vein,Thrombosis, Venous,Deep Venous Thrombosis,Deep-Vein Thrombosis,Deep-Venous Thrombosis,Deep Vein Thromboses,Deep Venous Thromboses,Deep-Vein Thromboses,Deep-Venous Thromboses,Phlebothromboses,Thromboses, Deep Vein,Thromboses, Deep Venous,Thromboses, Deep-Vein,Thromboses, Deep-Venous,Thromboses, Venous,Thrombosis, Deep Venous,Thrombosis, Deep-Vein,Thrombosis, Deep-Venous,Vein Thromboses, Deep,Vein Thrombosis, Deep,Venous Thromboses,Venous Thromboses, Deep,Venous Thrombosis, Deep