Cost of Long-Term Complications of Deep Venous Thrombosis of the Lower Extremities: An Analysis of a Defined Patient Population in Sweden

doi:10.1059/0003-4819-126-6-199703150-00006

Cost of Long-Term Complications of Deep Venous Thrombosis of the Lower Extremities: An Analysis of a Defined Patient Population in Sweden

David Bergqvist, PhD, MD;
Stefan Jendteg, BSc;
Lars Johansen, MD;
Ulf Persson, PhL, MPolSci; and
Knut Odegaard, PhD

From University Hospital, Uppsala, Sweden; Institute of Health Economics, Lund, Sweden; and Skovde Hospital, Skovde, Sweden. Acknowledgment: The authors thank Eva-Karin Johansson, RN, for compiling patient data and providing medical judgments. Grant Support: In part by Ciba-Geigy Limited, grant 00759 from the Swedish Medical Research Council, and the Swedish Heart and Lung Foundation. Requests for Reprints: Lars Johansen, MD, Department of Surgery, Skovde Hospital, S-541 85 Skovde, Sweden. Current Author Addresses: Dr. Bergqvist: Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden.

Abstract

Background: Little information is available on the epidemiology and economic effect of long-term complications developing after deep venous thrombosis.

Objective: To determine the extent of, timing of, and treatment costs associated with long-term complications developing after deep venous thrombosis of the lower extremities.

Design: 15-year retrospective cohort study.

Setting: County hospital in Sweden.

Patients: 257 patients with deep venous thrombosis and 241 age- and sex-matched controls without deep venous thrombosis.

Measurements: Data on use of health care resources and costs of inpatient and outpatient care, pharmaceutical agents, and treatment of complications.

Results: After 15 years of follow-up, 35% of the patients with thrombosis and 57% of the controls were alive. Two hundred forty-two complications were reported among the patients with thrombosis, and 25 similar events were reported among the controls. The average expected present value of the health care cost of treating complications of thrombosis was estimated to be about $4659 in the patients with thrombosis and $375 in the controls. In controls, primary deep venous thrombosis cost about $6000; thus, the additional long-term health care cost of post-thrombotic complications is about 75% of the cost of primary deep venous thrombosis.

Conclusions: The economic effect of post-thrombotic complications is considerable. The use of measures to prevent thromboembolism and its long-term complications are justified on both clinical and economic grounds.