An Economic Comparison of Enoxaparin and Warfarin in the Prevention of Deep Vein Thrombosis after Hip and Knee Replacement
Bibliographic record
Abstract
ABSTRACT Background and Objective: Deep vein thrombosis is a common complication in patients who have undergone hip and knee surgery. It is the principal cause of pulmonary embolism, which can result in death. This study was undertaken to compare the costs associated with enoxaparin and standard warfarin therapy in cases of hip and knee arthroplasty. Methods: This empiric cost comparison was based on patientspecific nursing workload, drug utilization, and diagnostic testing during the postoperative hospital stay. Multiple regression analysis was used to determine the impact of enoxaparin therapy on the cost per patient. Results: The expected cost for a patient without symptomatic deep vein thrombosis or comorbid conditions who underwent hip surgery and received enoxaparin was $1,244; this cost was $312 less than for a similar patient who received warfarin. The relationship was reversed for patients undergoing knee surgery: the expected cost per patient was $315 less for those receiving warfarin. Treating deep vein thrombosis and comorbid conditions added $2,438 and $455 respectively to hospital costs, irrespective of whether hip or knee surgery was performed. Conclusions: Enoxaparin anticoagulant therapy may yield economic benefits beyond the avoidance of deep vein thrombosis and pulmonary embolism. Hospital costs after hip surgery may be lower, primarily related to the use of nursing resources, even for patients who do not experience deep vein thrombosis. RESUME Generalites et objectif : La thrombose veineuse profonde est une complication courante chez les patients qui subissent une chirurgie de la hanche ou du genou. Elle est la cause principale de l’embolie pulmonaire qui peut entrainer la mort. Cette etude a ete menee pour comparer les couts associes au traitement a l’enoxaparine et au traitement standard a la warfarine dans les cas d’arthroplastie de la hanche et du genou. Methodes : Cette etude empirique de comparaison des couts a evalue les donnees relatives a la charge de travail du personnel infirmier, aux epreuves diagnostiques et a l’utilisation des medicaments durant le sejour hospitalier postoperatoire des patients ayant subi une arthroplastie de la hanche ou du genou. Une analyse de regression multiple a servi a determiner l’incidence du traitement a l’enoxaparine sur les couts pour chaque patient. Resultats : Les couts prevus pour un patient sans thrombose veineuse profonde symptomatique ou comorbidite, ayant subi une chirurgie de la hanche et recu de l’enoxaparine etaient de 1 244 $, soit 312 $ inferieurs a ceux d’un patient presentant un etat semblable et ayant recu de la warfarine. La relation etait toutefois inverses pour les patients ayant subi une chirurgie du genou ; les couts prevus etaient de 315 $ inferieurs pour ceux ayant recu de la warfarine. Le traitement d’une thrombose veineuse profonde et d’une comorbidite ont fait augmenter les frais hospitaliers de 2 438 $ et de 455 $ respectivement, peu importe s’il s’agissait d’une chirurgie de la hanche ou du genou. Conclusions : L’anticoagulotherapie a l’enoxaparine peut presenter un avantage economique, outre l’evitement de la thrombose veineuse profonde et l’embolie pulmonaire. Elle peut contribuer a reduire les frais hospitaliers suite a une chirurgie de la hanche, principalement par une charge de travail moindre pour le personnel infirmier, meme dans le cas des patients qui ne souffrent pas de thrombose veineuse profonde. Mots cles :
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".