Cost-effectiveness Analysis of Intraoperative Cell Salvage for Obstetric Hemorrhage
Anesthesiology, ISSN: 1528-1175, Vol: 128, Issue: 2, Page: 328-337
2018
- 48Citations
- 86Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Metrics Details
- Citations48
- Citation Indexes47
- 47
- CrossRef46
- Clinical Citations1
- PubMed Guidelines1
- Captures86
- Readers86
- 86
Article Description
Background: Cost-effectiveness analyses on cell salvage for cesarean delivery to inform national and societal guidelines on obstetric blood management are lacking. This study examined the cost-effectiveness of cell salvage strategies in obstetric hemorrhage from a societal perspective. Methods: Markov decision analysis modeling compared the cost-effectiveness of three strategies: use of cell salvage for every cesarean delivery, cell salvage use for high-risk cases, and no cell salvage. A societal perspective and lifetime horizon was assumed for the base case of a 26-yr-old primiparous woman presenting for cesarean delivery. Each strategy integrated probabilities of hemorrhage, hysterectomy, transfusion reactions, emergency procedures, and cell salvage utilization; utilities for quality of life; and costs at the societal level. One-way and Monte Carlo probabilistic sensitivity analyses were performed. A threshold of $100,000 per quality-Adjusted life-year gained was used as a cost-effectiveness criterion. Results: Cell salvage use for cases at high risk for hemorrhage was cost-effective (incremental cost-effectiveness ratio, $34,881 per quality-Adjusted life-year gained). Routine cell salvage use for all cesarean deliveries was not cost-effective, costing $415,488 per quality-Adjusted life-year gained. Results were not sensitive to individual variation of other model parameters. The probabilistic sensitivity analysis showed that at the $100,000 per quality-Adjusted life-year gained threshold, there is more than 85% likelihood that cell salvage use for cases at high risk for hemorrhage is favorable. Conclusions: The use of cell salvage for cases at high risk for obstetric hemorrhage is economically reasonable; routine cell salvage use for all cesarean deliveries is not. These findings can inform the development of public policies such as guidelines on management of obstetric hemorrhage. Visual Abstract: An online visual overview is available for this article at http://links.lww.com/ALN/B631.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85046574081&origin=inward; http://dx.doi.org/10.1097/aln.0000000000001981; http://www.ncbi.nlm.nih.gov/pubmed/29194062; https://journals.lww.com/10.1097/ALN.0000000000001981; http://Insights.ovid.com/crossref?an=00000542-201802000-00021; https://dx.doi.org/10.1097/aln.0000000000001981; https://insights.ovid.com/crossref?an=00000542-201802000-00021
Ovid Technologies (Wolters Kluwer Health)
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