Journal Article

Economic analysis of bleeding and thromboembolic sequelae after heart valve replacement (GELIA 7)

E. Müller and R. Bergemann

in European Heart Journal Supplements

Published on behalf of European Society of Cardiology

Volume 3, issue suppl_Q, pages Q65-Q69
Published in print December 2001 | ISSN: 1520-765X
Published online December 2001 | e-ISSN: 1554-2815 | DOI: http://dx.doi.org/10.1016/S1520-765X(01)90046-X
Economic analysis of bleeding and thromboembolic sequelae after heart valve replacement (GELIA 7)

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Aims To conduct an economic analysis of the coagulation-related complications bleeding and thromboembolism following heart valve replacement.

Method and results: Incidences of thromboembolic and bleeding events and subtypes in the German Experience with Low Intensity Anticoagulation (GELIA) study were determined. Based on these data, stroke incidences in a hypothetical cohort of 10,000 patients were calculated over a period of 10 years. Associated lifetime costs were assigned in order to estimate the economic burden of stroke. A cost-effectiveness ratio was estimated for patient self-management of anticoagulation. In the GELIA study severe thromboembolic and bleeding complications occurred at rates of 0·45% and 2·62% per patient-year, respectively. Within the thromboembolic complications stroke was the most common (62%), whereas bleeding events were dominated by gastrointestinal bleeds (38%). For 10,000 patients, costs associated with stroke management amounted to DM26 million for thromboembolic and DM54 million for bleeding events within 10 years. In the GELIA study, patient self-management reduced the incidence of severe complications by 30%. An evaluation of self-management for 5000 patients yielded a cost-effectiveness ratio of DM105,000 per life-year gained.

Conclusion Major differences exist between bleeding and thromboembolic events with respect to incidence, subtype and related costs. Strokes due to bleeding exert a higher economic burden than do thromboembolic strokes. The incidence of lethal strokes may be reduced by patient self-management at an acceptable cost-effectiveness ratio.

Keywords: Bleeding; cost-effectiveness ratio; economical aspects; heart valve replacement; thromboembolism

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

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