Background: This study assessed the potential cost-effectiveness of high (80-100%) vs low (21-35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was $216 compared with $222 for low FiO2 leading to a -$6 (95% confidence interval [CI]: -$13 to -$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with $195 for low FiO2 leading to a -$11 (95% CI: -$15 to -$6) difference in costs. In South Africa, the average cost for high FiO2 was $1164 compared with $1257 for low FiO2 leading to a -$93 (95% CI: -$132 to -$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a -1.05 (95% CI: -1.14 to -0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this.
Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries / Kachapila M.; Monahan M.; Ademuyiwa A.O.; Adinoyi Y.M.; Biccard B.M.; George C.; Ghosh D.N.; Glasbey J.; Morton D.G.; Osayomwanbo O.; Pearse R.; Roberts T.E.; Suroy A.; Yakubu S.Y.; Oppong R.; Bhangu A.; Aguilera M.L.; Alexander P.; Al-Saqqa S.W.; Borda-Luque G.; Costas-Chavarri A.; Drake T.M.; Ntirenganya F.; Fitzgerald J.E.; Fergusson S.J.; Ingabire J.C.A.; Ismaïl L.; Salem H.K.; Teddy Kojo A.T.; Lapitan M.C.; Lilford R.; Mihaljevic A.L.; Morton D.; Mutabazi A.Z.; Nepogodiev D.; Adisa A.O.; Ots R.; Pata F.; Pinkney T.; Poškus T.; Qureshi A.U.; Ramos-De la Medina A.; Rayne S.; Shaw C.A.; Shu S.; Spence R.; Smart N.; Tabiri S.; Harrison E.M.; Verjee A.; Runigamugabo E.; Khatri C.; Mohan M.; Jaffry Z.; Altamini A.; Kirby A.; Søreide K.; Recinos G.; Cornick J.; Modolo M.M.; Iyer D.; King S.; Arthur T.; Nahar S.N.; Waterman A.; Walsh M.; Agarwal A.; Zani A.; Firdouse M.; Rouse T.; Liu Q.; Correa J.C.; Talving P.; Worku M.; Arnaud A.; Kalles V.; Kumar B.; Kumar S.; Amandito R.; Quek R.; Ansaloni L.; Altibi A.; Venskutonis D.; Zilinskas J.; Poskus T.; Whitaker J.; Msosa V.; Tew Y.Y.; Farrugia A.; Borg E.; Bentounsi Z.; Gala T.; Al-Slaibi I.; Tahboub H.; Alser O.H.; Romani D.; Shu S.; Major P.; Mironescu A.; Bratu M.; Jovine E.; Solaini L.. - In: BJA OPEN. - ISSN 2772-6096. - ELETTRONICO. - 7:(2023), pp. 100207.1-100207.10. [10.1016/j.bjao.2023.100207]
Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries
Jovine E.;Solaini L.
2023
Abstract
Background: This study assessed the potential cost-effectiveness of high (80-100%) vs low (21-35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was $216 compared with $222 for low FiO2 leading to a -$6 (95% confidence interval [CI]: -$13 to -$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with $195 for low FiO2 leading to a -$11 (95% CI: -$15 to -$6) difference in costs. In South Africa, the average cost for high FiO2 was $1164 compared with $1257 for low FiO2 leading to a -$93 (95% CI: -$132 to -$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a -1.05 (95% CI: -1.14 to -0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this.| File | Dimensione | Formato | |
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