Burnhope Emma, Rodriguez-Guadarrama Yael, Waring Michael, Guilder Andrew, Malhotra Bharti, Razavi Reza, Rinaldi C A, Pennington Mark, Carr-White Gerald
a School of Biomedical Engineering and Imaging Sciences , Rayne Institute, Kings College London , London , UK.
b Cardiology, Guy's and St Thomas Hospital , London , UK.
J Med Econ. 2019 May;22(5):464-470. doi: 10.1080/13696998.2019.1581621. Epub 2019 Feb 20.
Infection is a serious and expensive complication of Cardiac Implantable Electronic Device (CIED) procedures. A retrospective based cost analysis was performed to estimate Trust level savings of using the TYRX antibacterial envelope as a primary prevention measure against infection in a tertiary referral centre in South London, UK.
A retrospective cohort of heart failure patients with reduced ejection fraction undergoing Implantable Cardioverter Defibrillator (ICD) or Cardiac Resynchronization Therapy (CRT) procedures were evaluated. Decision-analytic modelling was performed to determine economic savings of using the envelope during CIED procedure vs CIED procedure alone.
Over a 12 month follow-up period following CIED procedure, the observed infection rate was 3.14% (n = 5/159). The average cost of a CIED infection inpatient admission was £41,820 and, further to economic analysis, the additional costs attributable to infection was calculated at £62,213.94. A cost saving of £624 per patient by using TYRX during CIED procedure as a primary preventative measure against infection was estimated.
TYRX would be a cost-saving treatment option amongst heart failure patients undergoing ICD and CRT device procedures based on analysis in the local geographical area of South London. If upscaled to the UK population, we estimate potential cost savings for the National Health Service (NHS).
感染是心脏植入式电子设备(CIED)手术严重且代价高昂的并发症。在英国伦敦南部的一家三级转诊中心,进行了一项基于回顾性的成本分析,以估算使用TYRX抗菌包膜作为预防感染的主要措施时信托基金节省的费用。
对射血分数降低的心力衰竭患者进行植入式心脏复律除颤器(ICD)或心脏再同步治疗(CRT)手术的回顾性队列进行评估。进行决策分析建模,以确定在CIED手术中使用该包膜与单独进行CIED手术相比的经济节省情况。
在CIED手术后12个月的随访期内,观察到的感染率为3.14%(n = 5/159)。CIED感染住院患者的平均费用为41,820英镑,经经济分析,感染所致的额外费用计算为62,213.94英镑。估计在CIED手术期间使用TYRX作为预防感染的主要措施,每位患者可节省624英镑。
根据伦敦南部当地地区的分析,TYRX对于接受ICD和CRT设备手术的心力衰竭患者而言将是一种节省成本的治疗选择。如果推广至英国人口,我们估计可为国民医疗服务体系(NHS)节省潜在成本。