[Costs caused by bleeds within the therapy of acute coronary syndromes in Germany].
OBJECTIVE
To estimate the resources and subsequent costs, to manage bleeds among patients with acute coronary syndrome (ACS) who are treated with antithrombotics or antiplatelets. Bleeds are relatively common but there is little information on the resource use and costs associated with these bleeds. This paper provides estimates by type of bleed to be used in analyses of therapies for managing ACS patients.


METHODS
Retrospective chart review of ACS patients experiencing a bleed while hospitalized was conducted in Germany. Qualifying bleeds included symptomatic intracranial hemorrhage (IB), retroperitoneal hemorrhage (RB), gastrointestinal hemorrhage (GB), decrease in hemoglobin by > or = 3 g/dl (HA), puncture site bleed (PS), transfusion of > or = 2 units of blood products, and fatal bleeds.


RESULTS
Records of 59 German ACS patients were included in the analysis. The average cost per patient was 1,995 Euros. Costs by bleed type were 2,531 Euros (IB), 3,567 Euros (RB), 3,616 Euros (GB), 891 Euros (HA), 1,379 Euros (PS), and 5,415 Euros (transfusions).


CONCLUSIONS
German hospitals are paid by case severity and diagnosis. Understanding the full costs of managing ACS patients and related bleeds may help decision-making.
Medizinische Klinik 3 - Interventionelle Kardiologie, HELIOS Klinikum Wuppertal - Herzzentrum, Universität Witten/Herdecke, Herdecke, Germany. alexander.bufe@helios-kliniken.de
Alexander
A
Bufe
Simon
S
Frey
Stéphanie
S
Briswalter
D054058:Acute Coronary Syndrome / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000191:economics* / Q000627:therapeutic use*; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006470:Hemorrhage / Q000191:economics* / Q000453:epidemiology*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies
D000925:Anticoagulants