General prophylaxis with low-dose heparin minimized health care costs and thromboembolic complications in elective hip and general surgery, but increased hemorrhagic complications.
Does general thromboembolic prophylaxis reduce health care costs and complications compared to no prophylaxis in patients undergoing surgery?
General thromboembolic prophylaxis is cost-effective and minimizes complications in general and elective hip surgery, but not in cholelithiasis surgery.
Abstract The clinical and economic effects of each of 3 alternatives—no prophylaxis, general prophylaxis, and selective treatment—have been assessed in conjunction with 3 types of surgery—general surgery, the subset surgery for cholelithiasis, and elective hip surgery. The costs of thromboembolic and hemorrhagic complications have been calculated from the figures for 28 patients hospitalized at the Department of Surgery, Malmö General Hospital, Malmö, Sweden. The anticipated number of thromboembolic complications—and thus even the number of fatal pulmonary embolisms—can be minimized in all 3 types of surgery by means of general prophylaxis. General prophylaxis with low‐dose heparin is, however, accompanied by the greatest incidence of hemorrhagic complications . Health care costs are minimized with general prophylaxis in elective hip and general surgery, while no prophylaxis is the best alternative in surgery for cholelithiasis . From the patient's point of view, general prophylaxis minimizes the duration of thromboembolic disease in general surgery as well as in elective hip surgery. In surgery for cholelithiasis, however, no differences in health loss for the individual are shown between the 2 main alternatives, no prophylaxis and general prophylaxis . Selective treatment means treatment after diagnosis of thrombosis with some screening method. The alternative selective treatment was the least satisfactory of those 3 studied .
Bergqvist et al. (1988) studied General surgery, cholelithiasis surgery, and elective hip surgery (n=28). General prophylaxis (low-dose heparin) vs. No prophylaxis and selective treatment was evaluated on Clinical and economic effects (costs of thromboembolic and hemorrhagic complications). General prophylaxis with low-dose heparin minimized health care costs and thromboembolic complications in elective hip and general surgery, but increased hemorrhagic complications.