Aprotinin therapy is now widely used during cardiac surgery.
This study examined the clinical and economic effectiveness of high-dose or low-dose aprotinin in comparison to placebo.
In a double blind, randomized study, three groups of 50 patients received high-dose aprotinin costing AUS$614 per patient (AUS$=Australian dollars), low-dose aprotinin costing AUS$220 per patient or placebo.
Resource use influenced by aprotinin therapy was measured.
Both doses were effective in reducing chest drainage and postoperative transfusion requirements, high-dose being more effective than low-dose.
Both doses reduced the rate of reoperations for hemostasis.
A base case of statistically significant differences associated with the high-dose and low-dose aprotinin showed cost savings of AUS$77 and AUS$348 per patient, respectively.
If the demonstrated less significant reductions in operating room and ward stay are included, these savings become AUS$463 and AUS$715, respectively.
Alternately, if cross-matches are replaced by group-and-hold and cell savers are not used, the savings per patient would be AUS$196 and AUS$467, respectively.
While high-dose aprotinin is clinically more effective than low-dose aprotinin, low-dose therapy demonstrates greater cost savings.
Mots-clés Pascal : Circulation extracorporelle, Dose faible, Dose forte, Aprotinine, Etude comparative, Coût, Economie santé, Homme, Traitement associé, Chimiothérapie, Efficacité traitement, Antifibrinolytique, Inhibiteur enzyme, Peptidases, Hydrolases, Enzyme
Mots-clés Pascal anglais : Cardiopulmonary bypass, Low dose, High dose, Aprotinin, Comparative study, Costs, Health economy, Human, Combined treatment, Chemotherapy, Treatment efficiency, Antifibrinolytic, Enzyme inhibitor, Peptidases, Hydrolases, Enzyme
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0491753
Code Inist : 002B27A05A. Création : 22/03/2000.