Cost-Effectiveness of Preoperative Thrombophilia Screening in Free Flap Surgery
Author Information
Author(s): Bowman Kendra G. MD, PhD, Carty Matthew J. MD
Primary Institution: Brigham and Women's Hospital
Hypothesis
Preoperative screening for thrombophilias in free flap candidates may be cost-effective.
Conclusion
Preoperative thrombophilia screening may be a cost-effective measure for preventing thrombotic complications in free flap surgery.
Supporting Evidence
- The thrombotic complication rate was found to be 4.9%.
- A full thrombophilia screen breaks even when complication costs exceed $57,000 per patient.
- A limited screen breaks even at $39,000.
- 73% of flap thromboses are estimated to be attributable to thrombophilia.
Takeaway
This study looks at whether testing patients for blood clotting disorders before surgery can save money by preventing complications.
Methodology
The study used a retrospective review of free tissue transfers and developed a cost-effectiveness model based on complication rates and screening costs.
Potential Biases
Potential bias due to reliance on subjective assessments of complications and assumptions in the model.
Limitations
The study's thrombotic complication rate was based on subjective assessments, and the model relies on several assumptions that may not be accurate.
Participant Demographics
Patients undergoing free tissue transfer surgery at Brigham and Women's Hospital.
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