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Intensive Care Med. 2011 Mar;37(3):444-52. doi: 10.1007/s00134-010-2102-3. Epub 2010 Dec 9.

Cost-effectiveness of the Surviving Sepsis Campaign protocol for severe sepsis: a prospective nation-wide study in Spain.

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1
Unidad de Epidemiología y Evaluación, Instituto Universitario Fundación Parc Tauli, Universidad Autónoma de Barcelona, Sabadell (Barcelona), Spain. david.suarez.lamas@gmail.com

Abstract

CONTEXT:

Severe sepsis is associated with high mortality and increased costs. The 'Surviving Sepsis Campaign' (SSC) protocol was developed as an international initiative to reduce mortality. However, its cost-effectiveness is unknown.

OBJECTIVE:

To determine the cost-effectiveness of the SSC protocol for the treatment of severe sepsis in Spain after the implementation of an educational program compared with the conventional care of severe sepsis.

DESIGN:

Observational prospective before-and-after study.

SETTING:

59 medical-surgical intensive care units located throughout Spain.

PATIENTS:

A total of 854 patients were enrolled in the pre-educational program cohort (usual or standard care of severe sepsis) and 1,465 patients in the post-educational program cohort (SSC protocol care of severe sepsis).

INTERVENTIONS:

The educational program aimed to increase adherence to the SSC protocol. The SSC protocol included pharmacological and medical interventions.

MAIN OUTCOME MEASURES:

Clinical (hospital mortality) and economic (health-care resource and treatment costs) outcomes were recorded. A health-care system perspective was used for costs. The primary outcome was incremental cost-effectiveness ratio (ICER).

RESULTS:

Patients in the SSC protocol care cohort had a lower risk of hospital mortality (44.0% vs. 39.7%, P = 0.04). However, mean costs per patient were 1,736 euros higher in the SSC protocol care cohort (95% CI 114-3,358 euros), largely as a result of increased length of stay. Mean life years gained (LYG) were higher in the SSC protocol care cohort: 0.54 years (95% CI 0.02-1.05 years). The adjusted ICER of the SSC protocol was 4,435 euros per LYG. Nearly all (96.5%) the bootstrap replications were below the threshold of 30,000 euros per LYG.

CONCLUSION:

The SSC protocol seems to be a cost-effective option for treating severe sepsis in Spain.

PMID:
21152895
DOI:
10.1007/s00134-010-2102-3
[Indexed for MEDLINE]
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