COST-EFFECTIVE PREVENTION OF PULMONARY EMBOLUS IN HIGH-RISK TRAUMA PATIENTS

Objective: To define the cost-effectiveness of screening ultrasound (U S) and prophylactic inferior vena cava filters (VCF), approaches aimed at reducing the incidence of pulmonary embolus (PE) in high-risk trau ma patients. Design: Cost-effective analysis. Materials and Methods: W e constructed a decision tree with three approaches for PE prevention: no intervention, US, and VCF. Probabilities in each subtree were take n from published data, Sensitivity analyses evaluated all assumptions, probabilities, and outcomes for effects on baseline conclusions. Resu lts: US is more cost-effective than VCF, with a cost/PE prevented of $ 46,300 compared with $93,700. The strategies become equally cost-effec tive only when VCF are placed in the radiology suite and length of sta y is greater than or equal to 2 weeks. Conclusions: US is the most cos t-effective approach for PE prevention in high-risk trauma patients, V CF should be reserved for patients with an anticipated length of stay greater than or equal to 2 weeks who can safely have a filter placed i n the radiology suite.