Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27705, USA.
J Med Syst. 2010 Jun;34(3):379-86. doi: 10.1007/s10916-008-9250-9.
Thrombocytopenia is associated with increased patient risk. However, the costs of this complication are not well defined. This study assessed the impact of thrombocytopenia on in-hospital costs using results from CATCH, an observational study that examined 1988 consecutive patients receiving prolonged heparin therapy (> or =96 h). Thrombocytopenia was defined as: (group 1) an absolute reduction in platelet count to <150 x 10(9)/L; (group 2) a relative reduction in platelet count of >50% from admission levels; or (group 3) both criteria. We found that the development of thrombocytopenia was associated with significantly higher total in-hospital costs for all groups: (group 1) (difference, $8,222; 95% CI, $5,020-$11,425; P<.001); (group 2) (difference, $15,429; 95% CI, $7,472-$23,385; P<.001); and (group 3) (difference, $27,077; 95% CI, $22,901-$31,252; P<.001). However, in our adjusted model, longer lengths-of-stay and greater use of blood transfusions accounted for most incremental in-hospital cost differences.
血小板减少与患者风险增加相关。然而,这种并发症的成本尚未得到明确界定。本研究使用 CATCH 的研究结果评估了血小板减少对住院费用的影响,CATCH 是一项观察性研究,共纳入了 1988 例接受长期肝素治疗(> 96 小时)的连续患者。血小板减少定义为:(1 组)血小板计数绝对减少至 < 150 x 10(9)/L;(2 组)血小板计数较入院时水平下降> 50%;或(3 组)符合上述两种标准。我们发现,所有组别的血小板减少均与总住院费用显著增加相关:(1 组)(差异,$8222;95%置信区间,$5020-$11425;P<.001);(2 组)(差异,$15429;95%置信区间,$7472-$23385;P<.001);和(3 组)(差异,$27077;95%置信区间,$22901-$31252;P<.001)。然而,在我们的调整模型中,较长的住院时间和更多的输血使用解释了大部分增量住院费用差异。