Costs of bleeds relating to acute coronary syndrome therapies

Figures & data

Table 1.  Patient bleeding event types by country.

Type of bleed	France	Germany	Italy	Spain	Sweden	Total	%
Decreasing Hb	14	2	3	13	0	32	20.3
Decreasing Hb + puncture site	1	10	1	0	0	12	7.6
Puncture site only	4	30	5	0	16	55	34.8
Transfusion only	11	0	5	10	2	28	17.7
Transfusion + decreasing Hb	4	1	4	0	2	11	7.0
Transfusion + puncture site	2	0	9	0	2	13	8.2
Transfusion + decreasing Hb + puncture site	3	2	2	0	0	7	4.4
Total patients	39	45	29	23	22	158	100

Table 2.  Average number of procedures and transfusions per patient by bleeding type.

Procedure/ transfusion	Decreasing Hb + decreasing Hb + puncture site	Puncture site only	Any bleed requiring transfusion
CT scan	0.1	0.1	0.2
MRI	0	0	0.02
Ultrasound	0.5	0.8	0.5
Endoscopy	0.1	0	0.004
Transfused RBC	0	0	2.63
Transfused FFS	0	0	0.25
Transfused platelets	0	0	0.15

Table 3.  Average total LOS and LOS post-bleed in days by bleed type.

Country	Patients (n)	Average total LOS (median)	Total LOS range	Average LOS post-bleed date (median)	Bleed LOS range
Decreasing Hb + decreasing Hb with puncture site bleeding
France	15	9.1 (7)	2–30	4.5 (3)	0–16
Germany	12	7.5 (8)	2–16	6.3 (7)	2–11
Italy	4	9.8 (9.5)	6–14	6.0 (4)	3–13
Spain	13	15.4 (16)	3–41	12.8 (14)	1–40
Sweden	0
Overall	44	10.6 (8)	2–41	6.9 (6)	0–40
Puncture site only
France	4	7.5 (8)	3–11	3.5 (2)	1–9
Germany	30	8.1 (7)	1–26	6.4 (6)	0–13
Italy	5	9.4 (7)	5–21	5.2 (5)	4–7
Spain	0
Sweden	16	6.6 (6)	3–16	4.6 (4)	0–16
Overall	55	7.7 (7)	1–26	5.6 (5)	0–16
Any bleeding requiring transfusions
France	20	9.6 (8.5)	2–23	7.0 (5.5)	1–22
Germany	3	16.7 (23)	4–23	13.0 (14)	4–21
Italy	20	9.5 (9)	3–18	7.5 (6)	3–17
Spain	10	14.8 (11)	1–44	12.3 (8.5)	1–39
Sweden	6	11.5 (9)	4–23	10.3 (7)	3–23
Overall	59	11.3 (9)	1–44	8.4 (6)	1–39

LOS, length of stay, excludes patients with missing admission, discharge or bleeding dates.

Table 4.  Total cost (€) per patient by type of bleeding and cost post-bleeding by country and pooled data.

Country	DH + DH + P		PS only		Any transfusion
	Country data	Pooled data*	Country data	Pooled data*	Country data	Pooled data*
France	6,720	7,586	5,519	5,666	5,629	8,315
	(2,894)		(2,575)		(4,121)
Germany	4,038	5,551	4,343	4,146	8,974	6,084
	(3,365)		(3,446)		(6,999)
Italy	7,286	7,704	7,025	5,754	7,099	8,444
	(4,484)		(3,886)		(5,567)
Spain	9,914	6,732	–	4,146	10,252	7,379
	(8,370)				(8,032)
Sweden	–	6,262	3,986	4,677	6,985	6,864
			(2,809)		(6,277)

LOS, length of stay.

DH = decrease in Hb ≥3 g/dL; PS = puncture site bleed.

Costs after bleed date in brackets () for country specific resource use.

All costs are country-specific; *using latest cost data available (2007–2008).

*Resource use across all patients in sample with defined type of bleed and costed with country-specific data.