Cost-effective prevention of pulmonary embolus in high-risk trauma patients. J Trauma 1997 Mar;42(3):456-60; discussion 460-2
Date
03/01/1997Pubmed ID
9095113DOI
10.1097/00005373-199703000-00013Scopus ID
2-s2.0-0030946634 (requires institutional sign-in at Scopus site) 60 CitationsAbstract
OBJECTIVE: To define the cost-effectiveness of screening ultrasound (US) and prophylactic inferior vena cava filters (VCF), approaches aimed at reducing the incidence of pulmonary embolus (PE) in high-risk trauma patients.
DESIGN: Cost-effective analysis.
MATERIALS AND METHODS: We constructed a decision tree with three approaches for PE prevention: no intervention, US, and VCF. Probabilities in each subtree were taken from published data. Sensitivity analyses evaluated all assumptions, probabilities, and outcomes for effects on baseline conclusions.
RESULTS: US is more cost-effective than VCF, with a cost/PE prevented of $46,300 compared with $93,700. The strategies become equally cost-effective only when VCF are placed in the radiology suite and length of stay is > or = 2 weeks.
CONCLUSIONS: US is the most cost-effective approach for PE prevention in high-risk trauma patients. VCF should be reserved for patients with an anticipated length of stay > or = 2 weeks who can safely have a filter placed in the radiology suite.
Author List
Brasel KJ, Borgstrom DC, Weigelt JAMESH terms used to index this publication - Major topics in bold
AgedCost-Benefit Analysis
Decision Trees
Gravity Suits
Heparin
Humans
Middle Aged
Pulmonary Embolism
Risk Factors
Sensitivity and Specificity
Thrombosis
Ultrasonography
Vena Cava Filters
Wounds and Injuries
