Department of Orthopaedic Surgery, Hahnemann University Hospital, Drexel University College of Medicine, Philadelphia, PA.
Department of Orthopaedic Surgery, Philadelphia Veteran's Affairs Hospital, The University of Pennsylvania, Philadelphia, PA.
J Arthroplasty. 2019 Jul;34(7S):S307-S311. doi: 10.1016/j.arth.2019.02.042. Epub 2019 Feb 27.
This article presents a break-even analysis for intraoperative Betadine lavage for the prevention of infection in total hip arthroplasty (THA) and total knee arthroplasty (TKA).
Protocol costs, baseline infection rates after arthroplasty, and average revision costs were obtained from institutional records and the literature. The break-even analysis determined the absolute risk reduction (ARR) in infection rate required for cost effectiveness.
At our institutional price of $2.54, dilute (0.35%) Betadine lavage would be cost effective if initial infection rates of both TKA (1.10%) and THA (1.63%) have an ARR of 0.01%. At a hypothetical lowest cost of $0.50, the ARR is so low as to be immediately cost effective. At a hypothetical high price of $40.00, Betadine is cost effective with ARRs of 0.16% (TKA) and 0.13% (THA).
Intraoperative Betadine lavage, at typical institutional prices, can be highly cost effective in reducing infection after joint arthroplasty.
本文对全髋关节置换术（THA）和全膝关节置换术（TKA）中使用聚维酮碘术中冲洗以预防感染的成本效益进行了盈亏平衡分析。
从医院记录和文献中获得方案成本、关节置换术后的基线感染率和平均翻修成本。盈亏平衡分析确定了感染率的绝对风险降低（ARR），以达到成本效益。
在我们医院的价格为 2.54 美元的情况下，如果 TKA（1.10%）和 THA（1.63%）的初始感染率的 ARR 为 0.01%，则稀释（0.35%）聚维酮碘冲洗将具有成本效益。在假设的最低成本 0.50 美元的情况下，ARR 如此之低，以至于立即具有成本效益。在假设的高价格 40.00 美元的情况下，聚维酮碘冲洗具有成本效益，ARR 分别为 0.16%（TKA）和 0.13%（THA）。
在典型的机构价格下，聚维酮碘术中冲洗可以非常有效地降低关节置换术后的感染率。
