Analysis of disease patterns and cost of treatments for prevention of deep venous thrombosis after total knee or hip replacement: results from the Practice Analysis of THromboprophylaxis after Orthopaedic Surgery (PATHOS) study

Figures & data

Table 1 Demographic characteristics

n	10,389
Males (n, %)	3516 (33.8%)
Age (years, mean ± SD)	70.9 ± 9.5
THR/TKR procedure	5483 (52.8%)/4906 (47.2%)
Previous hospital admissions
Cardiovascular reasons	540 (5.2%)
Ulcer	210 (2.0%)
Other	67 (0.6%)
No previous hospital admission	9572 (92.1%)
Previous treatments (more frequent combinations)
Anti-inflammatory agents + antihypertensives	3212 (30.9%)
Antihypertensives	1541 (14.8%)
Anti-inflammatory agents	1534 (14.8%)
Anti-inflammatory agents + corticosteroids + antihypertensives	896 (8.6%)
Anti-inflammatory agents + corticosteroids	412 (4.0%)
Anti-inflammatory agents + antihypertensives + cardiovascular therapy	412 (4.0%)
No previous treatment	1537 (14.8%)

Abbreviations: THR, total hip replacement; TKR, total knee replacement; SD, standard deviation.

Table 2 First prescription of antiplatelet therapy during the first 6 months of follow-up and treatment changes

	n	%	Patients with a treatment change
			n	%
THR
No AT use	828	15.1%	–	–
Heparin	1760	32.1%	454	25.8%
Enoxaparin	2224	40.6%	502	22.6%
Antiplatelet	362	6.6%	64	17.7%
VKAs	135	2.5%	17	12.6%
Fondaparinux	70	1.3%	22	31.4%
Combination	104	1.9%	99	95.2%
Total	5483		1158	21.1%
TKR
No AT use	617	12.6%	–	–
Heparin	1992	40.6%	527	26.5%
Enoxaparine	1713	34.9%	463	27.0%
Antiplatelet	296	6.0%	66	22.3%
VKAs	141	2.9%	29	20.6%
Fondaparinux	66	1.3%	28	42.4%
Combination	81	1.7%	76	93.8%
Total	4906		1189	24.2%

Abbreviations: THR, total hip replacement; TKR, total knee replacement; AT, antithrombotic treatment; VKAs, vitamin K antagonists.

Table 3 Cost and length of stay for main procedure according to complications

	Cost in €		Length of stay
	Median (p25–p75)	Mean ± SD	Median (p25–p75)	Mean ± SD
Overall
THR	9052.00 (8063.00–9084.96)	8733.61 ± 2227.10	9.0 (6.0–12.0)	10.4 ± 7.9
TKR	9052.00 (8063.00–9084.96)	8677.23 ± 1228.52	9.0 (6.0–10.0)	9.2 ± 5.0
CV during procedure
THR	9052.00 (8156.00–9084.96)	9317.86 ± 5681.89	9.0 (7.0–14.0)	11.9 ± 17.7
TKR	9052.00 (8156.00–9052.00)	8997.47 ± 1426.23	8.0 (6.0–10.0)	10.1 ± 7.9
VTE during procedure
THR	9324.00 (9144.72–9324.00)	9788.47 ± 2363.83	16.0 (12.0–18.0)	16.4 ± 5.5
TKR	9324.00 (8759.00–9324.00)	9123.10 ± 1884.56	11.0 (9.0–13.0)	11.6 ± 5.4
No complications
THR	9052.00 (8063.00–9084.96)	8665.67 ± 1402.91	9.0 (6.0–12.0)	10.2 ± 6.1
TKR	9052.00 (8063.00–9084.96)	8646.06 ± 1200.55	9.0 (6.0–10.0)	9.1 ± 4.6

Abbreviations: THR, total hip replacement; TKR, total knee replacement; SD, standard deviation; p25/p75, 25th/75th percentile; CV, cardiovascular event; VTE, venous thromboembolism.

Table 4 Cost of treatments and outpatient specialist services related and not related to THR/TKR

	Related		n	%	Not related		n	%
	Median (p25–p75)	Mean ± SD			Median (p25–p75)	Mean ± SD
Treatment costs
THR at 1 month	68.84 (34.42–130.76)	63.90 ± 72.28	4020	73.3%	30.41 (11.83–61.00)	26.76 ± 88.20	2922	53.3%
TKR at 1 month	68.84 (34.41–130.00)	69.67 ± 72.52	3847	78.4%	32.94 (14.04–64.68)	33.53 ± 96.01	3235	65.9%
THR at 3 months	68.84 (32.91–135.44)	81.13 ± 94.53	4525	82.5%	65.27 (26.51–128.31)	80.19 ± 195.71	4176	76.2%
TKR at 3 months	73.48 (32.91–136.00)	83.87 ± 89.10	4189	85.4%	74.60 (33.55–140.91)	96.80 ± 235.28	4254	86.7%
THR at 6 months	73.00 (34.12–137.68)	90.11 ± 111.42	4655	84.9%	123.71 (46.78–244.00)	161.65 ± 312.09	4547	82.9%
TKR at 6 months	75.42 (34.13–137.68)	90.97 ± 97.88	4289	87.4%	142.06 (61.15–265.24)	188.95 ± 347.06	4489	91.5%
Outpatient specialist services costs
THR at 1 month	23.80 (9.60–54.93)	22.11 ± 70.64	2205	40.2%	22.21 (10.67–40.60)	15.73 ± 89.12	1904	34.7%
TKR at 1 month	21.20 (7.20–44.50)	23.24 ± 76.49	2023	41.2%	20.08 (8.50–38.04)	21.37 ± 248.84	1814	37.0%
THR at 3 months	46.98 (22.98–82.45)	69.42 ± 125.22	4595	83.8%	40.30 (19.72–88.55)	63.11 ± 243.79	3739	68.2%
TKR at 3 months	43.22 (23.29–86.13)	75.11 ± 137.91	4049	82.5%	40.84 (19.75–90.96)	78.60 ± 791.55	3398	69.3%
THR at 6 months	71.05 (37.37–126.30)	104.05 ± 159.55	4947	90.2%	81.60 (36.05–172.64)	147.18 ± 519.14	4481	81.7%
TKR at 6 months	65.58 (32.90–127.70)	111.52 ± 176.63	4449	90.7%	82.52 (35.27–186.17)	169.68 ± 1324.79	4096	83.5%

Abbreviations: THR, total hip replacement; TKR, total knee replacement; SD, standard deviation; p25/p75, 25th/75th percentile.

Table 5 Costs (drugs, outpatient specialist services, hospitalizations) for patients with and without complications: first 6 months of follow-up

THR/TKR	Complications		Drugs and OSS		Hospitalizations
			Median (p25–p75)	Mean ± SD	Median (p25–p75)	Mean ± SD
THR	Without CC	n, %	4626 (84.4)
		At 1 month	66.82 (18.36–130.80)	90.45 ± 106.20
		At 3 months	112.60 (57.22–188.30)	153.27 ± 161.30
		At 6 months	141.85 (78.86–234.11)	194.74 ± 201.03
THR	With CC	n, %	857 (15.6)
		At 1 month	40.50 (0.00–89.21)	62.89 ± 82.26	3920.00 (1580.34–5250.00)	3782.67 ± 3632.44
		At 3 months	98.84 (51.72–166.73)	136.32 ± 138.14	4900.00 (3157.96–6261.00)	5473.70 ± 4988.68
		At 6 months	147.62 (79.40–232.13)	191.20 ± 175.58	5145.00 (3500.00–7177.50)	6555.87 ± 6603.28
TKR	Without CC	n, %	4174 (85.1)
		At 1 month	66.70 (14.04–129.35)	95.87 ± 107.96
		At 3 months	115.83 (55.10–197.33)	158.80 ± 162.29
		At 6 months	146.11 (78.40–238.06)	199.64 ± 197.65
TKR	With CC	n, %	732 (14.9)
		At 1 month	51.74 (4.00–103.26)	76.77 ± 96.80	4165.00 (2250.00–5250.00)	3966.61 ± 3188.19
		At 3 months	108.43 (54.10–179.25)	159.98 ± 172.72	4900.00 (3338.94–5800.00)	5188.32 ± 4262.58
		At 6 months	147.77 (88.08–253.11)	217.97 ± 223.98	5000.00 (3500.00–6550.00)	5850.20 ± 4738.77

Abbreviations: THR, total hip replacement; TKR, total knee replacement; OSS, outpatient specialist services; SD, standard deviation; p25/p75, 25th/75th percentile.