Cost-Effectiveness Analysis of a Transparent Antimicrobial Dressing for Managing Central Venous and Arterial Catheters in Intensive Care Units
| Autor: | Anastasiia Motrunich, Stéphanie F. Bernatchez, Jean-François Timsit, Maria Palka-Santini, Stéphane Ruckly, Franck Maunoury |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Cost-Benefit Analysis lcsh:Medicine law.invention Randomized controlled trial law Intensive care medicine Humans Intensive care medicine lcsh:Science Aged Probability Aged 80 and over Multidisciplinary business.industry Chlorhexidine lcsh:R Cost-effectiveness analysis Middle Aged Intensive care unit Bandages Confidence interval Markov Chains Clinical trial Intensive Care Units Catheter-Related Infections Number needed to treat Anti-Infective Agents Local lcsh:Q Female business Vascular Access Devices medicine.drug Research Article |
| Zdroj: | PLoS ONE PLoS ONE, Vol 10, Iss 6, p e0130439 (2015) |
| ISSN: | 1932-6203 |
| Popis: | Objective To model the cost-effectiveness impact of routine use of an antimicrobial chlorhexidine gluconate-containing securement dressing compared to non-antimicrobial transparent dressings for the protection of central vascular lines in intensive care unit patients. Design This study uses a novel health economic model to estimate the cost-effectiveness of using the chlorhexidine gluconate dressing versus transparent dressings in a French intensive care unit scenario. The 30-day time non-homogeneous markovian model comprises eight health states. The probabilities of events derive from a multicentre (12 French intensive care units) randomized controlled trial. 1,000 Monte Carlo simulations of 1,000 patients per dressing strategy are used for probabilistic sensitivity analysis and 95% confidence intervals calculations. The outcome is the number of catheter-related bloodstream infections avoided. Costs of intensive care unit stay are based on a recent French multicentre study and the cost-effectiveness criterion is the cost per catheter-related bloodstream infections avoided. The incremental net monetary benefit per patient is also estimated. Patients 1000 patients per group simulated based on the source randomized controlled trial involving 1,879 adults expected to require intravascular catheterization for 48 hours. Intervention Chlorhexidine Gluconate-containing securement dressing compared to non-antimicrobial transparent dressings. Results The chlorhexidine gluconate dressing prevents 11.8 infections /1,000 patients (95% confidence interval: [3.85; 19.64]) with a number needed to treat of 85 patients. The mean cost difference per patient of €141 is not statistically significant (95% confidence interval: [€-975; €1,258]). The incremental cost-effectiveness ratio is of €12,046 per catheter-related bloodstream infection prevented, and the incremental net monetary benefit per patient is of €344.88. Conclusions According to the base case scenario, the chlorhexidine gluconate dressing is more cost-effective than the reference dressing. Trial Registration This model is based on the data from the RCT registered with www.clinicaltrials.gov (NCT01189682). |
| Databáze: | OpenAIRE |
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