Premier database (2011)(2012) and augmented with the published literature. All costs were adjusted to 2013 dollars. The model estimated the costs associated with the following utilization outcomes: procedure time, transfusion rate, intensive care unit (ICU) length of stay (LOS), and general ward LOS. The following adverse events were considered: myocardial infarction, respiratory failure, acute renal failure, stroke/TIA, and second endovascular procedure within 12 months of the initial procedure. Sensitivity analysis was performed to assess the impact of imputed data, and one-way sensitivity analysis was performed for each parameter. Results: The expected costs for a hospital related to the above utilization and adverse event were $8,463 for Medtronic's stent graft system and $11,380 for the Competition. Fifty-six percent of the $2,917 difference was attributable to improved utilization associated with Medtronic's stent graft compared to the Competition. Adverse events and secondary endovascular procedures accounted for 25% and 19% of the difference, respectively. These results were robust to alternative sensitivity analyses. ConClusions: This analysis suggested that Medtronic's current stent graft is associated with cost savings compared to Competition for the above parameters. Future research is necessary to examine if these results are maintained based upon a head-to-head clinical study of EVAR stent systems.
Longitudinal Health Insurance Database during [2000][2001][2002][2003][2004][2005][2006][2007][2008]. VTE cases were identified based on the disease diagnosis coding and anticoagulant prescription or surgical thrombectomy procedure from the claims of inpatient or emergency care. Using risk set sampling, ten controls were selected for each case, matched on age (± 5 years), entry date (± 180 days), cancer diagnosis and major surgery procedure. Use of antipsychotics classified into typical antipsychotics (TAPs) and atypical antipsychotics (AAPs) was evaluated in the 365 days prior to an index date. Confounding was adjusted using a summary risk score for VTE during conditional multiple logistic regressions. Results: A total of 1,616 VTE cases and 16,026 controls were identified. Any use of TAPs was associated with a 1.26-fold (95% CI, 1.06-1.50) increased VTE risk compared with nonuse. The risk varied depending on specific TAP-use scenarios, with the greatest risk being observed for parenteral administration (OR adj , 1.82; 95% CI, 1.14-2.91), followed by high-average-daily dose (> 5 mg of olanzapine-equivalent dose; OR adj , 1.75; 95% CI, 1.23-2.50), long-term use (> 30 days; OR adj , 1.59; 95% CI, 1.17-2.17), and current use of TAPs (OR adj , 1.54; 95% CI, 1.15-2.07). Conversely, the insignificant association between AAP use and VTE risk was found and remained across the abovementioned drug-use conditions. ConClusions: Use of TAPs but not AAPs is associated with an increased VTE risk. Health care professionals should be vigilant about VTE development in postmenopausal women receiving TAPs, especially for those receiving parenteral administration or high doses of TAPs.
Conflito de interesses:Os autores declaram não haver nenhum interesse profissional ou pessoal que possa gerar conflito de interesses em relação a este manuscrito.
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