Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries.

NIHR Global Health Research Unit on Global Surgery Collaborators, (2023) Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries. BJA open, 7. 100207-.

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Official URL: http://dx.doi.org/10.1016/j.bjao.2023.100207

Abstract

<h4>Background</h4>This study assessed the potential cost-effectiveness of high (80-100%) <i>vs</i> low (21-35%) fraction of inspired oxygen (FiO<sub>2</sub>) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa.<h4>Methods</h4>Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO<sub>2</sub>, 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 ($).<h4>Results</h4>High FiO<sub>2</sub> may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO<sub>2</sub> was $216 compared with $222 for low FiO<sub>2</sub> leading to a -$6 (95% confidence interval [CI]: -$13 to -$1) difference in costs. In India, the average cost for high FiO<sub>2</sub> was $184 compared with $195 for low FiO<sub>2</sub> leading to a -$11 (95% CI: -$15 to -$6) difference in costs. In South Africa, the average cost for high FiO<sub>2</sub> was $1164 compared with $1257 for low FiO<sub>2</sub> leading to a -$93 (95% CI: -$132 to -$65) difference in costs. The high FiO<sub>2</sub> arm had few SSIs, 7.33% compared with 8.38% for low FiO<sub>2,</sub> leading to a -1.05 (95% CI: -1.14 to -0.90) percentage point reduction in SSIs.<h4>Conclusion</h4>High FiO<sub>2</sub> could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this.

Item Type:	Article
Uncontrolled Keywords:	NIHR Global Health Research Unit on Global Surgery Collaborators
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User:	Symplectic Admin
Date Deposited:	31 Jan 2024 10:16
Last Modified:	13 Mar 2024 05:19
DOI:	10.1016/j.bjao.2023.100207
Open Access URL:	https://doi.org/10.1016/j.bjao.2023.100207
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3178164