4CPS-203 Antibiotic stewardship programme interventions in a third level hospital in spain: a one-year review

Abstract

LSP 2.5g/50 mL: 1500C ¼ . Cost calculated by rounding to the number of vials (for example, 4F-PCC 1600IU=4 vials). Currently, daily hospital stay cost in a surgical unit =258,8C ¼ /day. Results 691 patients included,148(21,0%) anticoagulated. 25 (4,0%) excluded because of no surgery, so the final analysis included 666 patients,141 anticoagulated. 63(44,7%) were anticoagulated with acenocoumarol, 40(28,4%) apixaban, 29 (20,6%) rivaroxaban, 12(8,5%) dabigatran, 8(5,7%) edoxaban and 1(0,7%) with warfarin. Early surgical goal in orthogeriatric patients in Spain (proximal femur fracture in patients >65 years) is intervention in <48 hours since admission. It was only achieved in 12,8% of anticoagulated patients in 2020 and 2021(18). Meantime between admission and surgery =4 ± 6 days. Days between admission and surgery =574 for all anticoagulated patients in total. Estimated total cost of anticoagulant reversal =134.683,5C ¼ (955,2C ¼ /patient). Assuming this strategy is used and surgery is performed in the first 24 hours, hypothetical hospitalisation cost could decrease, saving 574 admission days and 148.537,3C ¼ . Conclusion and RelevanceEarly hip fracture surgery within 48 hours from admission reduces complications in elderly patients. Anticoagulation reversal strategies in anticoagulated patients have a significant economic impact but would allow to reduce hospital stay with potential savings in healthcare costs.