Economic Burden of Venous Thromboembolism in Patients Undergoing Major Abdominal Surgery

Abstract Background Venous thromboembolism (VTE) is a serious complication that arises after major abdominal surgery. VTE poses risks of negative outcomes and health care burden. The literature on the cost of VTE in Japanese surgical patients, however, is scarce. Objective This study was conducted to investigate the economic consequences of VTE in Japanese patients with major abdominal surgery, using a hospital claims database. Methods This is a retrospective, matched cohort study. Patients who had a VTE event up to 90 days after their first major abdominal surgery and initiated warfarin or heparin within 1 day of VTE diagnosis with continued treatment for more than 4 weeks were matched with controls for surgery type, hospital, and date of surgery ± 6 months in a 1:2 scheme. The primary outcome was 90-day costs associated with major abdominal surgery. The secondary outcomes were 6-month total costs, average length of initial inpatient stay, and cost of initial inpatient stay. Results The 90-day cumulative incidence of VTE was 4.89%. The development of a VTE event in patients undergoing major abdominal surgery resulted in a 1.5-fold increase in the length of hospitalization and a 2.8-fold increase in total costs 90 days after the surgery. Total costs further increased to 3.4-fold at 6 months. Overall, costs incurred in patients with VTE are on average much higher than in patients without VTE throughout 6-month postsurgery. Conclusions The preventive care for VTE using more effective prophylactic treatment is recommended to reduce the economic burden associated with major abdominal surgery.