Safety and cost-effectiveness analysis of using intermittent inflation and compression device during drug anticoagulation window period after artificial knee arthroplasty

Abstract

Objective To analyze the safety and cost-effectiveness of intermittent pneumatic compression (IPC) during the intermittent pneumatic interval after total knee arthroplasty (TKA). Methods A total of 337 patients who underwent TKA surgery were included and randomly divided into experimental group (n=168) and control group (n=169). The experimental group continued to use IPC for both lower limbs during the anticoagulant window period, while the control group continued to use IPC for both lower limbs immediately after surgery to the time of getting out of bed. Muscular calf vein thrombosis (MCVT) prevention rate, D2 polymer level, total postoperative blood loss, and cost-effectiveness ratio were compared between the 2 groups in 1 d after surgery. Results There were no statistical significances in MCVT prevention effective rate, hemoglobin level, total blood loss, and D2 polymer level between the 2 groups in 1 d after surgery. The IPC time was 6.00 (6.00, 6.00) h in the experimental group, significantly shorter than that in the control group [20.00 (15.00, 24.25) h, P < 0.01]. The total cost of IPC was significantly lower in the experimental group than the control group [172.84 (172.84, 172.84) vs 628.37 (461.82, 758.49) Yuan, P < 0.01]. The cost-effectiveness ratio of the experimental group (2.23) was lower than that of the control group (7.75). Conclusion The use of IPC during the anticoagulant window after TKA has good safety and better cost-effectiveness than the continuous use of IPC after surgery.

Keywords

• total knee arthroplasty
• intermittent pneumatic compression
• drug anticoagulation
• drug window period
• cost-effectiveness