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Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Economic evaluation of pharmacologic pre- and postconditioning with sevoflurane compared with total intravenous anesthesia in liver surgery : a cost analysis
Authors : Eichler, Klaus
Urner, Martin
Twerenbold, Claudia
Kern, Sabine
Brügger, Urs
Spahn, Donat R.
Beck-Schimmer, Beatrice
Ganter, Michael T.
DOI : 10.21256/zhaw-3976
Published in : Anesthesia & Analgesia
Volume(Issue) : 124
Issue : 3
Pages : 925
Pages to: 933
Issue Date: 2017
Publisher / Ed. Institution : Lippincott Williams & Wilkins
ISSN: 0003-2999
Language : English
Subjects : Anesthesia; Methyl ether; Postoperative complication; Cost-Benefit analysis
Subject (DDC) : 338: Production
617: Surgery
Abstract: Background: Pharmacologic pre- and postconditioning with sevoflurane compared with total IV anesthesia in patients undergoing liver surgery reduced complication rates as shown in 2 recent randomized controlled trials. However, the potential health economic consequences of these different anesthesia regimens have not yet been assessed. Methods: An expostcost analysis of these 2 trials in 129 patients treated between 2006 and 2010 was performed. We analyzed direct medical costs for in-hospital stay and compared pharmacologic pre- and postconditioning with sevoflurane (intervention) with total IV anesthesia (control) from the perspective of a Swiss university hospital. Year 2015 costs, converted to US dollars, were derived from hospital cost accounting data and compared with a multivariable regression analysis adjusting for relevant covariables. Costs with negative prefix indicate savings and costs with positive prefix represent higher spending in our analysis. Results: Treatment-related costs per patient showed a nonsignificant change by -12,697 US dollars (95% confidence interval [CI], 10,956 to -36,352; P = 0.29) with preconditioning and by -6139 US dollars (95% CI, 6723 to -19,000; P = 0.35) with postconditioning compared with the control group. Results were robust in our sensitivity analysis. For both procedures (control and intervention) together, major complications led to a significant increase in costs by 86,018 US dollars (95% CI, 13,839-158,198; P = 0.02) per patient compared with patients with no major complications. Conclusions: In this cost analysis, reduced in-hospital costs by pharmacologic conditioning with sevoflurane in patients undergoing liver surgery are suggested. This possible difference in costs compared with total IV anesthesia is the result of reduced complication rates with pharmacologic conditioning, because major complications have significant cost implications.
Fulltext version : Published version
License (according to publishing contract) : CC BY-ND 4.0: Attribution - NoDerivatives 4.0 International
Departement: School of Management and Law
Organisational Unit: Winterthur Institute of Health Economics (WIG)
Published as part of the ZHAW project : Pharmacological pre-/postconditioning in liver surgery: a cost effectiveness study
Appears in Collections:Publikationen School of Management and Law

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