title: Clinical and health costs impact of progress in diagnosis and treatment in venous thromboembolic disease: evolution in 15 years.
abstract: BACKGROUND
  The therapeutic and diagnostic approach in deep vein thrombosis (DVT) has changed enormously in the last two decades with the introduction of ultrasound, low-molecular-weight heparin (LMWH), and premature motion. The aim of this study is to evaluate these changes and analyze their clinical and economic aspects.
  
  
  METHODS
  We registered all inpatients with a diagnosis of DVT during 1994 (n=110) and 2009 (n=75) and their sociodemographic and clinical features in a descriptive observational design. We performed a comparison of diagnostic techniques, length of stay, inpatient complications, and costs thus derived for both series, based on 2009 prices, so that we could get comparable results.
  
  
  RESULTS
  Ninety-one percent of inpatients in 1994 were diagnosed by venography, whereas, in 2009, the diagnosis was based on clinical features, D-dimer, and ultrasound in 100% of patients. Inpatient treatment went from 7% LMWH in 1994 to 96% in 2009, and as outpatient from 82% acenocumarol to 90.6% LMWH. Complications decreased by 13.3%. Length of stay was 2.7 higher in 1994. Globally, the cost per patient decreased by 63.39%, based primarily on reduced length of stay.
  
  
  CONCLUSIONS
  The current diagnostic and therapeutic approach in DVT allows for effective treatment, fewer complications, and a drastic reduction in inpatient costs.
authors: Department of Angiology and Vascular Surgery, San Cecilio University Hospital, Granada, Spain.
authors: Blanca
authors: B
authors: Vera-Arroyo
authors: Jose Patricio
authors: JP
authors: Linares-Palomino
authors: Silvia
authors: S
authors: Lozano-Alonso
authors: Juan Jose
authors: JJ
authors: Moreno-Villalonga
authors: Alejandra
authors: A
authors: Bravo-Molina
authors: Eduardo
authors: E
authors: Ros-Die
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000191:economics / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006495:Heparin, Low-Molecular-Weight / Q000191:economics / Q000627:therapeutic use; D017721:Hospital Costs; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D010690:Phlebography / Q000191:economics; D011237:Predictive Value of Tests; D012042:Registries; D013997:Time Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000097:blood / Q000175:diagnosis / Q000191:economics / Q000628:therapy
chemical_list: D000925:Anticoagulants; D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D006495:Heparin, Low-Molecular-Weight; C036309:fibrin fragment D