- 作者：A. Sicras-Mainar ; M. De Salas-Cansado ; M.B. Ruiz-Antor¨¢n ; D. Cuesta-Peredo ; I. Lizano-D¨ªez ; L. Beteg¨®n-Nicolas ; R. Navarro-Artieda
- 关键词：Artroplastia primaria ; Cadera ; Rodilla ; Trombosis ; Sangrado ; Costes sanitarios
- 刊名：Revista Espa?ola de Cirug¨ªa Ortop¨¦dica y Traumatolog¨ªa
- 出版年：2012
- 出版时间：September-October, 2012
- 年：2012
- 卷：56
- 期：5
- 页码：341-353
- 全文大小：323 K
Objective
To 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 methods
This multicentre observational and retrospective study extracted data from the medical records of three Spanish public hospitals (2010). Patients ¡Ý 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.
Results
A 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; 8,766.4 and 6,496.1 respectively; P<.05. All grouped results were comparable between them according to the hospital analysed and the type of replacement.
Conclusions
Costs were higher for thrombosis and bleeding patients, respectively. Costs were associated with length of stay and hospital-acquired infections.