Cristin-resultat-ID: 827745
Sist endret: 23. mars 2018 16:27
Resultat
Rapport
2011

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

Bidragsytere:
  • Tove Ringerike
  • Vida Hamidi
  • Gunhild Hagen
  • Åsmund Reikvam og
  • Marianne Klemp

Utgiver/serie

Utgiver

Nasjonalt kunnskapssenter for helsetjenesten

Serie

Rapport fra Kunnskapssenteret
ISSN 1890-1298
e-ISSN 1890-1298
NVI-nivå 0

Om resultatet

Rapport
Publiseringsår: 2011
Hefte: 13/2011
Antall sider: 92
ISBN: 978-82-8121-414-9
Open Access

Klassifisering

Fagfelt (NPI)

Fagfelt: Samfunnsmedisin
- Fagområde: Medisin og helsefag

Beskrivelse Beskrivelse

Tittel

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

Sammendrag

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.

Bidragsytere

Tove Ringerike

  • Tilknyttet:
    Forfatter
    ved Folkehelseinstituttet

Vida Hamidi

  • Tilknyttet:
    Forfatter
    ved Folkehelseinstituttet

Gunhild Hagen

  • Tilknyttet:
    Forfatter
    ved Folkehelseinstituttet

Åsmund Reikvam

  • Tilknyttet:
    Forfatter
    ved Folkehelseinstituttet
Aktiv cristin-person

Marianne Klemp

Bidragsyterens navn vises på dette resultatet som Marianne Klemp
  • Tilknyttet:
    Forfatter
    ved Avdeling for global helse ved Folkehelseinstituttet
1 - 5 av 5