Thromboprophylactic treatment with rivaroxaban or dabigatran compared with enoxaparin or dalteparin in patients undergoing elective hip- or knee replacement surgery

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	Thromboprophylactic treatment with rivaroxaban or dabigatran compared with enoxaparin or dalteparin in patients undergoing elective hip- or knee replacement surgery
	Ringerike, Tove; Hamidi, Vida; Hagen, Gunhild; Reikvam, Åsmund; Klemp, Marianne
	2011-06
出版年	2011
语种	英语
国家	挪威
出版者	Norwegian Knowledge Centre for the Health Services
领域	气候变化
英文摘要	ENGLISH: 1-page key messages Due to a high risk of thromboembolism in patients undergoing major orthopaedic surgery it has become standard practice to give thromboprophylactic treatment to these patients. Pharmaceutical interventions with or without addition of mechanical methods are recommended. This project, commissioned by Helse Bergen HF Ortopedisk klinikk, examined thromboprophylaxis with rivaroxaban or dabigatran compared with low-molecular weight heparins (LMWH, i.e. enoxaparin and dalteparin) with regard to efficacy, safety and cost-effectiveness in patients undergoing elective total hip or knee replacement surgery. We conducted a systematic review of the literature and made cost-effectiveness analyses based on a model that calculated quality-adjusted life years and life time costs. The main findings were that: •We did not find statistically significant differences between dabigatran and enoxaparin for mortality, pulmonary embolism, deep vein thrombosis or major bleeding. The quality of the evidence ranged from very low to moderate. •For rivaroxaban compared with enoxaparin we found statistically a significant reduction in deep vein thrombosis, but also a trend towards increased risk of major bleeding. For mortality and pulmonary embolism there were no statistically significant differences between treatments. The quality of the evidence ranged from very low to moderate. •Our results indicate a great uncertainty regarding which strategy is the most cost-effective. However, rivaroxaban and enoxaparin had a slightly higher probability of being cost-effective alternatives for patients undergoing total hip or knee replacement, respectively. •The results of our model analysis of the uncertainty surrounding each group of parameters indicated that more research on efficacy data would have the greatest impact on reducing decision uncertainty.
英文关键词	VDP::Medisinske Fag: 700 VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Ortopedisk kirurgi: 784 Ortopedi Arthroplasty, Replacement, Hip
URL	查看原文
来源平台	Center for International Climate and Environmental Research-Oslo (CICERO)
文献类型	科技报告
条目标识符	http://119.78.100.173/C666/handle/2XK7JSWQ/1686
专题	气候变化
推荐引用方式 GB/T 7714	Ringerike, Tove,Hamidi, Vida,Hagen, Gunhild,et al. Thromboprophylactic treatment with rivaroxaban or dabigatran compared with enoxaparin or dalteparin in patients undergoing elective hip- or knee replacement surgery:Norwegian Knowledge Centre for the Health Services,2011.