Acta chirurgica Scandinavica. Supplementum最新文献_第4页

The cost-effectiveness of prevention of post-operative thromboembolism. 预防术后血栓栓塞的成本效益。

Acta chirurgica Scandinavica. Supplementum Pub Date : 1990-01-01

D Bergqvist, T Mätzsch, S Jendteg, B Lindgren, U Persson

{"title":"The cost-effectiveness of prevention of post-operative thromboembolism.","authors":"D Bergqvist, T Mätzsch, S Jendteg, B Lindgren, U Persson","doi":"","DOIUrl":"","url":null,"abstract":"In recent years, value for money in health care has become of increasing concern. There are various ways to perform an economic evaluation, the most simple being a cost-effectiveness analysis, where differences in costs will influence the choice between methods. Cost-utility and cost-benefit analyses represent more advanced forms of economic evaluations. In this cost-effectiveness analysis, the following three strategies aimed at solving the problem of post-operative thromboembolic complications were compared: (a) no prophylaxis but treatment of occurring complications, (b) general prophylaxis with low-dose heparin for patients over 40 years of age and (c) selective treatment based on post-operative surveillance with a fibrinogen uptake test. Moreover, these alternatives were evaluated for three types of surgery: general abdominal surgery, cholecystectomy and elective hip surgery. Costs for thromboembolic and haemorrhagic complications were estimated from data available for patients hospitalized in Malmö. A sensitivity analysis was made with regard to the frequency of thrombosis, prophylactic effect and treatment costs. Health care costs would be minimized with general prophylaxis in hip and general surgery, whereas no prophylaxis is the most cost-effective alternative in cholecystectomy patients, i.e. with a frequency of thrombosis below 8%. General prophylaxis minimized the duration of patients' health losses due to thromboembolic disease in general, as well as in elective hip surgery. After cholecystectomy, no difference in health loss for the individual was found between the alternative of no prophylaxis and general prophylaxis. Selective treatment was always the least satisfactory alternative in all categories and always the most expensive.","PeriodicalId":7309,"journal":{"name":"Acta chirurgica Scandinavica. Supplementum","volume":"556 ","pages":"36-41"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13281092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The optimal approach to the treatment of acute femoro-popliteal occlusion. 急性股腘窝闭塞的最佳治疗方法。

Acta chirurgica Scandinavica. Supplementum Pub Date : 1990-01-01

H van Urk

引用次数: 0

Prevention of venous thrombosis in patients undergoing major orthopaedic surgical procedures. 骨科大手术患者静脉血栓形成的预防。

Acta chirurgica Scandinavica. Supplementum Pub Date : 1990-01-01

J Hirsh

引用次数: 0

Pre-surgical identification of the patient at risk for developing venous thromboembolism post-operatively. 术前对术后静脉血栓栓塞危险患者的识别。

Acta chirurgica Scandinavica. Supplementum Pub Date : 1990-01-01

D P Brandjes, J W ten Cate, H R Buller

{"title":"Pre-surgical identification of the patient at risk for developing venous thromboembolism post-operatively.","authors":"D P Brandjes, J W ten Cate, H R Buller","doi":"","DOIUrl":"","url":null,"abstract":"The pre-surgery identification of patients at risk for the development of post-operative venous thromboembolism has not yet been achieved. It is a well recognized fact that major surgery without prophylaxis encompasses a high risk for thrombosis, in particular orthopaedic operations (hip/knee surgery approximately 50%) and abdominal surgery (approximately 20%). Other well-defined risk factors, though rarely occurring, are deficiencies of the major inhibitors of blood coagulation (i.e. protein C, protein S and antithrombin III). Less well-defined risk factors are a history of previous thrombosis, obesity, varicosis, cancer etc. In an attempt to identify patients at risk for thrombosis prior to surgery, several investigators have developed complicated risk predictors, i.e. formulae comprising combinations of coagulation test results and physical characteristics such as body weight. However, the clinical usefulness has only been demonstrated in two small studies evaluating gynaecological surgery patients. These prognostic indices have not, however, found general acceptance and are not used routinely. The importance of all these risk factors for patient management with regard to thrombosis prevention is relatively small. Irrespective of the absence or presence of identified risk factors, currently the majority of patients will receive some formal thrombosis prophylaxis. The major problem at present is the development of proximal vein thrombosis despite the best possible thrombosis prophylaxis (approximately 10% after hip surgery). Identification of these patients pre-operatively or in an early stage in the post-operative phase by single screening tests should be a major research issue. Furthermore, the development of a prophylactic regimen which eliminates proximal deep vein thrombosis is still desperately needed.","PeriodicalId":7309,"journal":{"name":"Acta chirurgica Scandinavica. Supplementum","volume":"556 ","pages":"18-21"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13438492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Venous thromboembolism--managing the risk. Proceedings of a symposium. Berlin, October 6-7, 1989. 静脉血栓栓塞——控制风险。研讨会记录。柏林，1989年10月6日至7日。

Acta chirurgica Scandinavica. Supplementum Pub Date : 1990-01-01

引用次数: 0

How to predict which patient with carotid atherosclerosis is "high risk". 如何预测哪些颈动脉粥样硬化患者属于“高危”。

Acta chirurgica Scandinavica. Supplementum Pub Date : 1990-01-01

T Schroeder

引用次数: 0

Adjuvant medical therapy to improve patency rate following reconstruction for atherosclerosis obliterans (ASO). 辅助药物治疗提高动脉粥样硬化闭塞症(ASO)重建后通畅率。

Acta chirurgica Scandinavica. Supplementum Pub Date : 1990-01-01

M Lepäntalo

引用次数: 0