Document Detail


Impact of postoperative venous thromboembolism on Medicare recipients undergoing total hip replacement or total knee replacement surgery.
MedLine Citation:
PMID:  20720243     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The impact of postoperative venous thromboembolism (VTE) during initial hospitalization for total hip replacement (THR) or total knee replacement (TKR) surgery was assessed.
METHODS: Using Medicare Provider Analysis and Review files, patients who underwent THR, TKR, or hip fracture surgery from 2005 to 2007 were identified using appropriate procedure codes from the International Classification of Diseases, 9th Revision, Clinical Modification. Medicare managed care patients were excluded from the study. Eligible patients were classified as having had deep venous thrombosis (DVT), pulmonary embolism (PE), DVT and PE, or no VTE during their initial hospitalization. Risk adjustment was performed using propensity score matching. Medicare cost, cost to beneficiaries, and cost to primary payers were analyzed to determine risk-adjusted differences in outcome measures, including mortality, rehospitalization, bleeding, length of stay, and total health care expenditures related to VTE events.
RESULTS: A total of 170,047 patients were identified. Postoperative VTE events occurred in 3,014 patients (1.77%) during their initial hospitalization. Risk-adjusted mortality rates were three to four times higher for patients with VTE compared with those without VTE. Patients with VTE were more likely to be rehospitalized and experience bleeding within 30 days. Risk-adjusted differences in annual mean cost, including Medicare cost and costs to beneficiaries and primary payers, were significantly greater for patients with VTE.
CONCLUSION: Patients who developed VTE after THR or TKR had a higher likelihood of mortality, bleeding, and rehospitalization; were hospitalized longer; and incurred higher costs to Medicare, Medicare beneficiaries, and private payers compared with patients without VTE.
Authors:
Onur Baser; Dylan Supina; Nishan Sengupta; Li Wang; Louis Kwong
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists     Volume:  67     ISSN:  1535-2900     ISO Abbreviation:  Am J Health Syst Pharm     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-19     Completed Date:  2010-11-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503023     Medline TA:  Am J Health Syst Pharm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1438-45     Citation Subset:  IM    
Affiliation:
STATinMED Research, Ann Arbor, MI, USA. obaser@statinmed.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip / adverse effects,  economics*
Arthroplasty, Replacement, Knee / adverse effects,  economics*
Female
Health Care Costs / statistics & numerical data
Hemorrhage / etiology
Hip Fractures / economics,  surgery
Hospitalization / economics
Humans
Length of Stay / economics
Male
Medicare
Patient Readmission / economics,  statistics & numerical data
Postoperative Complications / economics*,  mortality
Pulmonary Embolism / economics,  etiology,  mortality
Retrospective Studies
United States
Venous Thromboembolism / economics*,  etiology,  mortality

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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