Cost-effective prevention of pulmonary embolus in high-risk trauma patients

Karen J. Brasel, David C. Borgstrom, John A. Weigelt

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

Objective: To define the cost-effectiveness of screening ultrasound (US) and prophylactic inferior vena cava filters (VCF), approaches aimed at reducing the incidence of pulmonary embolus (PE) in high-risk trauma patients. Design: Cost-effective analysis. Materials and Methods: We constructed a decision tree with three approaches for PE prevention: no intervention, US, and VCF. Probabilities in each subtree were taken from published data. Sensitivity analyses evaluated all assumptions, probabilities, and outcomes for effects on baseline conclusions. Results: US is more cost-effective than VCF, with a cost/PE prevented of $46,300 compared with $93,700. The strategies become equally cost-effective only when VCF are placed in the radiology suite and length of stay is ≤ 2 weeks. Conclusions: US is the most cost-effective approach for PE prevention in high-risk trauma patients. VCF should be reserved for patients with an anticipated length of stay ≤ 2 weeks who can safely have a filter placed in the radiology suite.

Original languageEnglish (US)
Pages (from-to)456-462
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume42
Issue number3
DOIs
StatePublished - Mar 1 1997

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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