BJA Open. 2023 Jul 15;7:100207. doi: 10.1016/j.bjao.2023.100207. eCollection 2023 Sep.
This study assessed the potential cost-effectiveness of high (80-100%) low (21-35%) fraction of inspired oxygen (FiO) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa.
Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO, 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 ($).
High FiO may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO was $216 compared with $222 for low FiO leading to a -$6 (95% confidence interval [CI]: -$13 to -$1) difference in costs. In India, the average cost for high FiO was $184 compared with $195 for low FiO leading to a -$11 (95% CI: -$15 to -$6) difference in costs. In South Africa, the average cost for high FiO was $1164 compared with $1257 for low FiO leading to a -$93 (95% CI: -$132 to -$65) difference in costs. The high FiO arm had few SSIs, 7.33% compared with 8.38% for low FiO leading to a -1.05 (95% CI: -1.14 to -0.90) percentage point reduction in SSIs.
High FiO could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this.
本研究评估了在尼日利亚、印度和南非，高（80%-100%）、低（21%-35%）吸入氧分数（FiO）预防腹部手术后手术部位感染（SSI）的潜在成本效益。
使用从正在进行的评估高FiO有效性的试点试验的非捆绑数据、已发表文献以及尼日利亚、印度和南非的成本调查中获取的最佳现有证据构建决策分析模型。有效性以术后30天SSI的百分比衡量，采用医疗保健视角，成本以美元（$）报告。
高FiO可能具有成本效益（更便宜且有效）。在尼日利亚，高FiO的平均成本为216美元，低FiO为222美元，成本差异为 -6美元（95%置信区间[CI]：-13至-1美元）。在印度，高FiO的平均成本为184美元，低FiO为195美元，成本差异为 -11美元（95%CI：-15至-6美元）。在南非，高FiO的平均成本为1164美元，低FiO为1257美元，成本差异为 -93美元（95%CI：-132至-65美元）。高FiO组的SSI较少，为7.33%，而低FiO组为8.38%，导致SSI减少了 -1.05个百分点（95%CI：-1.14至-0.90）。
高FiO在这三个国家预防SSI方面可能具有成本效益，但需要大型临床试验的进一步数据来证实这一点。
