PROPHYLAXIS FOR VENOUS THROMBOEMBOLISM IN HIP FRACTURE SURGERY - TOTAL COSTS AND COST-EFFECTIVENESS IN THE NETHERLANDS

Fracture of the hip is one of most significant risk factors for develo pment of deep vein thrombosis (DVT) and its complications. A number of pharmacological prophylactic methods are currently available which ca n reduce the incidence of postoperative thromboembolism in patients un dergoing surgery for fracture of the hip. A retrospective analysis of controlled clinical studies was performed to examine in this patient g roup the total cost of prevention and treatment, and the cost effectiv eness in terms of lives saved, of 5 prophylactic regimens - oral antic oagulants, dextran, low dose heparin, low molecular weight (LMW)-hepar in and danaparoid sodium - compared with clinical diagnosis and conven tional treatment of DVT only, Our results show that the total cost, in cluding the savings in treatment of the complications of DVT, of each prophylactic regimen is less than the total cost of no prophylaxis. Th us, prophylaxis may not only save lives but may also lead to lower cos ts of care (including prophylaxis costs). The total cost of the new an tithrombotic danaparoid sodium is less than that of the other forms of prophylaxis considered and danaparoid sodium appears to be the most c ost-effective modality. We conclude that general use of danaparoid sod ium in surgery for hip fracture is the most efficient approach to decr easing the incidence of postoperative morbidity and mortality and redu cing healthcare expenses for the complications of DVT.