Costs of bleeds relating to acute coronary syndrome therapies.
To estimate the costs to manage selected types of bleeding complications in patients with acute coronary syndrome (ACS) treated with antithrombotics, including antiplatelet, and fibrinolytic therapies: decrease in haemoglobin >3 g/dL, puncture site, and bleeding requiring transfusion of blood products.


METHODS
Retrospective chart reviews of ACS patients experiencing decrease in Hb, puncture site, or bleeding requiring transfusion were conducted in hospitals in France, Germany, Italy, Spain and Sweden to determine the total length of stay (LOS), stay post-bleeding, procedures to identify the extent of bleeding, number and types of transfusion products, patient demographics, reason for hospital admission and disposition upon discharge. Country-specific costs were applied to estimate the average cost per patient by type of bleeding event.


RESULTS
Records of 158 ACS patients with the bleeding complications were examined (26.9% decrease in Hb, 35.5% puncture site, and 37.8% transfusion). The average LOS was 10.6 days for decreasing Hb, 7.7 days for puncture site bleeding, and 11.3 days for patients receiving transfusions due to these bleeding events. The average costs per patient ranged between €3,986 and €10,252. The LOS ranged widely both within and across countries.


CONCLUSIONS
The study has a small sample size and costs are confounded by co-morbidities.


CONCLUSIONS
The estimated costs for decreasing Hb, puncture site bleeding and bleeding resulting in transfusions provide a tool for researchers to conduct economic analyses of bleeding events associated with therapies for ACS.
Bufe
Alexander
A
Universitaetsklinik der Universitat Witten/Herdecke, Wuppertal, Germany.
Emile
Ferrari
F
Drogoul
Laurent
L
Guindo Soldevila
Josep
J
Giuseppe
Di Pasquale
DP
Maddalena
Lettino
L
Janzon
Magnus
M
Brown
Ruth E
RE
D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000191:economics; D015897:Comorbidity; D005060:Europe; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects* / Q000191:economics; D006454:Hemoglobins; D006470:Hemorrhage / Q000191:economics* / Q000209:etiology*; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011677:Punctures / Q000009:adverse effects* / Q000191:economics; D012189:Retrospective Studies
D005343:Fibrinolytic Agents; D006454:Hemoglobins