A recent study published in Journal of Bone and Joint Surgery has suggested that aspirin is a cost effective choice for venous thromboembolism after hip replacement surgery in patients who did not have history of venous thromboembolism.
The study by Schousboe and colleagues has been published in July issue of Journal of Bone and Joint Surgery.
However, the study said that the preferred choice following total knee arthroplasty depends on age and is uncertain for those younger than eighty years old.
Schousboe and colleagues used a 1-month Markhov cohort model for their study. Markhov model is a type of statistical model to assess the parameters.
The researchers compared treatment 14 days after total hip arthroplasty and total knee arthroplasty with 160 mg of aspirin or low-molecular-weight heparin in patients who were aged 55 years, 60 years, 65 years, 70 years, 75 years, 80 years and 85 years.
To compare the treatment patients were grouped as
– Healthy after surgery
– No postphlebitic syndrome after venous thromboembolism
– Postphlebitic syndrome after venous thromboembolism
The authors estimated lifetime costs, quality adjusted lifetime years gained, and costs per quality adjusted lifetime year gained for both type of approaches [aspirin versus low molecular weight heparin.
The reults were as follow
- For patients undeergoing total hip arthroplasty 55-75 years, costs per quality adjusted life year gained for low-molecular-weight heparin compared with aspirin were $315,000 and $1.4 million, respectively.
- For those between 80-85 years aspirin cost less and saved more quality adjusted life year than low-molecular-weight heparin.
- For patients undergoing total knee arthroplasty at the ages of 55, 70,85 years, costs per quality adjusted life year gained with low-molecular-weight heparin were $36,000, $112,000, and $448,000, respectively.
The authors confirmed a low probability of low-molecular-weight heparin being cost-effective for patients undergoing total hip arthroplasty and for those with an age of eighty years or older undergoing total knee arthroplasty.
For individuals younger than eighty years of age undergoing total knee arthroplasty, the cost-effectiveness of low-molecular-weight heparin compared with aspirin is uncertain.
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