Abstract
Thrombocytopenia is associated with increased patient risk. However, the costs of this complication are not well defined. This study assessed the impact of thrombocytopenia on in-hospital costs using results from CATCH, an observational study that examined 1988 consecutive patients receiving prolonged heparin therapy (≥96 h). Thrombocytopenia was defined as: (group 1) an absolute reduction in platelet count to <150 × 109/L; (group 2) a relative reduction in platelet count of >50% from admission levels; or (group 3) both criteria. We found that the development of thrombocytopenia was associated with significantly higher total in-hospital costs for all groups: (group 1) (difference, $8,222; 95% CI, $5,020–$11,425; P < .001); (group 2) (difference, $15,429; 95% CI, $7,472–$23,385; P < .001); and (group 3) (difference, $27,077; 95% CI, $22,901–$31,252; P < .001). However, in our adjusted model, longer lengths-of-stay and greater use of blood transfusions accounted for most incremental in-hospital cost differences.
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Berkowitz, S. D., Sane, D. C., Sigmon, K. N., et al., Occurrence and clinical significance of thrombocytopenia in a population undergoing high-risk percutaneous coronary revascularization. Evaluation of c7E3 for the Prevention of Ischemic Complications (EPIC) Study Group. J. Am. Coll. Cardiol. 32(2):311–319, 1998. doi:10.1016/S0735-1097(98)00252-6.
Eikelboom, J. W., Anand, S. S., Mehta, S. R., Weitz, J. I., Yi, C., and Yusuf, S., Prognostic significance of thrombocytopenia during hirudin and heparin therapy in acute coronary syndrome without ST elevation: Organization to Assess Strategies for Ischemic Syndromes (OASIS-2)study. Circulation. 103(5):643–650, 2001.
Harrington, R. A., Sane, D. C., Califf, R. M., et al., Clinical importance of thrombocytopenia occurring in the hospital phase after administration of thrombolytic therapy for acute myocardial infarction. The Thrombolysis and Angioplasty in Myocardial Infarction Study Group. J. Am. Coll. Cardiol. 23(4):891–898, 1994.
Oliveira, G. B., Crespo, E. M., Becker, R. C., et al., Incidence and prognostic significance of thrombocytopenia in patients treated with prolonged heparin therapy. Arch. Intern. Med. 168(1):94–102, 2008. doi:10.1001/archinternmed.2007.65.
Ohman, E. M., Granger, C. B., Rice, L., et al., Identification,diagnosis and treatment of heparin-induced thrombocytopenia and thrombosis: a registry of prolonged heparin use and thrombocytopenia among hospitalized patients with and without cardiovascular disease. The Complication After Thrombocytopenia Caused by Heparin (CATCH) Registry steering committee. J. Thromb. Thrombolysis. 19(1):11–19, 2005. doi:10.1007/s11239-005-0850-7.
Warkentin, T. E., and Greinacher, A., Heparin-induced thrombocytopenia: recognition, treatment, and prevention: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 126(Suppl 3):311S–337S, 2004. doi:10.1378/chest.126.3_suppl.311S.
Eisenstein, E. L., and Mark, D. B., Cost effectiveness of new diagnostic tools and therapies for acute coronary syndromes. In: Topol, E. J. (Ed.), Acute Coronary Syndromes. New York: Marcel Dekker, pp. 723–745, 2004.
Eisenstein, E. L., Yusuf, S., Bindal, V., et al., What is the economic value of digoxin therapy in congestive heart failure patients? Results from the DIG trial. J. Card. Fail. 12(5):336–342, 2006. doi:10.1016/j.cardfail.2006.04.002.
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Funding for this project was provided by Berlex Laboratories of Montville, NJ and The Medicines Company of Parsippany, NJ.
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Eisenstein, E.L., Honeycutt, E.F., Anstrom, K.J. et al. Economic Assessment of Thrombocytopenia: CATCH Registry. J Med Syst 34, 379–386 (2010). https://doi.org/10.1007/s10916-008-9250-9
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DOI: https://doi.org/10.1007/s10916-008-9250-9