PB1525 - Healthcare Resource Utilization in Pregnant Women with Suspected Antithrombin Deficiency: Results from a Nationwide Hospital Chargemaster Database

Background: Antithrombin (AT) deficiency is a high-risk thrombophilia that can cause venous thromboembolic events (VTE) during pregnancy and postpartum, leading to increased maternal morbidity and mortality, as well as healthcare resource utilization.

Aims: To report healthcare resource utilization trends among pregnant women with suspected antithrombin deficiency using real-world data.

Methods: From a de-identified, nationwide chargemaster dataset (Premier Healthcare Database), we extracted real-world data on pregnant women who had a delivery-related admission (1/2016–1/2019). We included all women suspected to have AT deficiency, defined as having received AT 12 months before or after their index delivery-related encounter. The outcomes of interest were length of stay (LOS), ICU admission, and ICU LOS at the delivery-related encounter and 1-year postpartum healthcare costs (total costs and costs attributed to VTE and coagulopathy events [e.g., disseminated intravascular coagulation]).

Results: A total of 38 women were identified as having suspected antithrombin deficiency (mean ± SD age: 28.1 ± 5.6 years). The overall median hospital LOS at the delivery-related encounter was 3.5 days. A total of 7 (18.4% of 38) patients required ICU admission during their delivery-related hospital encounter, with a median ICU LOS of 18.4 days. The median total healthcare cost among all patients 1-year postpartum was $85,080, of which $58,636 was attributed to VTE-related events (n=13 women) and $68,885 was attributed to coagulopathy-related events (n=22 women).

Conclusion(s): Our findings show significant healthcare resource utilization among pregnant women with suspected AT deficiency, based on hospital/ICU LOS, total costs, and costs attributed to coagulopathy and VTE events in the year after delivery. These findings are especially relevant compared to the average 1-year postpartum healthcare costs for commercially insured patients (range: $3,667–$4,634), as reported by the 2016 Health Care Cost Institute.