Jp. Burke et al., EVALUATION OF THE FINANCIAL IMPACT OF KETOROLAC TROMETHAMINE THERAPY IN HOSPITALIZED-PATIENTS, Clinical therapeutics, 18(1), 1996, pp. 197-211
This retrospective cohort study aimed to determine the resource utiliz
ation and cost consequences of ketorolac tromethamine in postoperative
pain management in a variety of clinical circumstances. All patients
were treated at LDS Hospital, Salt Lake City, Utah, a 520-bed teaching
hospital. A long-term archive of clinical and financial data from a c
omputerized hospital information system was searched for patients with
specified primary International Classification of Diseases, 9th Revis
ion, Clinical Modification discharge diagnoses treated from June 1, 19
90, to July 1, 1992, who received ketorolac (n = 229). These patients
were matched with cohort patients (n = 821) treated from July 1, 1989,
to May 31, 1990, who did not receive ketorolac. The archive contained
information on ketorolac exposure as well as concurrent drug therapy
and adverse drug events that had been prospectively evaluated during h
ospitalization throughout the study and cohort periods. Detailed costs
were available for each patient. The study examined attributable diff
erences in lengths of stay and total costs using linear regression mod
eling. We found a statistically significant attributable decreased len
gth of stay for ketorolac patients of 1.15 days. Case patients also ha
d reduced usage of narcotic drugs (4.39 fewer doses than cohorts and 1
5.6 hours shorter duration of narcotics than cohorts), reduced use of
antiemetic and antipruritic medications, and reduced numbers of advers
e events. Linear regression modeling showed that ketorolac use was sig
nificantly related to reduced cost using inflation-adjusted dollars. W
e believe that ketorolac has significant cost advantages over opiate a
nalgesics because of its narcotic-sparing effects. Advantages of ketor
olac use inelude reduced rates of adverse drug events, reduced lengths
of stay, especially for orthopedic surgery, and reduced overall hospi
tal costs for diagnosis-related groups associated with cholecystectomy
.