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Annals of Vascular Surgery
Tipo de obra :
Autre
Naturaleza de la obra :
Oeuvre
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Cost-Effectiveness Analysis of the Use of a Prophylactic Antibiotic for Patients Undergoing Lower Limb Amputation due to Diabetes or Vascular Illness in Colombia / Carlos Oliver Valderrama Molina
Título : Cost-Effectiveness Analysis of the Use of a Prophylactic Antibiotic for Patients Undergoing Lower Limb Amputation due to Diabetes or Vascular Illness in Colombia Tipo de documento : documento electrónico Autores : Carlos Oliver Valderrama Molina, Fecha de publicación : 2017 Títulos uniformes : Annals of Vascular Surgery Idioma : Inglés (eng) Resumen : Background: The use of a prophylactic antibiotic in an amputation surgery is a key element for the successful recovery of the patient. We aim to determine, from the perspective of the Colombian health system, the cost-effectiveness of administering a prophylactic antibiotic among patients undergoing lower limb amputation due to diabetes or vascular illness in Colombia. Methods: A decision tree was constructed to compare the use and nonuse of a prophylactic antibiotic. The probabilities of transition were obtained from studies identified from a systematic review of the clinical literature. The chosen health outcome was reduction in mortality due to prevention of infection. The costs were measured by expert consensus using the standard case methodology, and the resource valuation was carried out using national-level pricing manuals. Deterministic sensitivity, scenarios, and probabilistic analyses were conducted. Results: In the base case, the use of a prophylactic antibiotic compared with nonuse was a dominant strategy. This result was consistent when considering different types of medications and when modifying most of the variables in the model. The use of a prophylactic antibiotic ceases to be dominant when the probability of infection is greater than 48%. Conclusions: The administration of a prophylactic antibiotic was a dominant strategy, which is a conclusion that holds in most cases examined; therefore, it is unlikely that the uncertainty around the estimation of costs and benefits change the results. We recommend creating policies oriented toward promoting the use of a prophylactic antibiotic during amputation surgery in Colombia. Mención de responsabilidad : Mateo Ceballos, Luis Esteban Orozco, Carlos Oliver Valderrama, Diana Isabel Londoño, Luz Helena Lugo Referencia : Ann Vasc Surg. 2017 Apr;40:327-334. DOI (Digital Object Identifier) : 10.1016/j.avsg.2016.07.090 PMID : 27903479 En línea : https://linkinghub.elsevier.com/retrieve/pii/S0890-5096(16)31245-6 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4086 Cost-Effectiveness Analysis of the Use of a Prophylactic Antibiotic for Patients Undergoing Lower Limb Amputation due to Diabetes or Vascular Illness in Colombia [documento electrónico] / Carlos Oliver Valderrama Molina, . - 2017.
Obra : Annals of Vascular Surgery
Idioma : Inglés (eng)
Resumen : Background: The use of a prophylactic antibiotic in an amputation surgery is a key element for the successful recovery of the patient. We aim to determine, from the perspective of the Colombian health system, the cost-effectiveness of administering a prophylactic antibiotic among patients undergoing lower limb amputation due to diabetes or vascular illness in Colombia. Methods: A decision tree was constructed to compare the use and nonuse of a prophylactic antibiotic. The probabilities of transition were obtained from studies identified from a systematic review of the clinical literature. The chosen health outcome was reduction in mortality due to prevention of infection. The costs were measured by expert consensus using the standard case methodology, and the resource valuation was carried out using national-level pricing manuals. Deterministic sensitivity, scenarios, and probabilistic analyses were conducted. Results: In the base case, the use of a prophylactic antibiotic compared with nonuse was a dominant strategy. This result was consistent when considering different types of medications and when modifying most of the variables in the model. The use of a prophylactic antibiotic ceases to be dominant when the probability of infection is greater than 48%. Conclusions: The administration of a prophylactic antibiotic was a dominant strategy, which is a conclusion that holds in most cases examined; therefore, it is unlikely that the uncertainty around the estimation of costs and benefits change the results. We recommend creating policies oriented toward promoting the use of a prophylactic antibiotic during amputation surgery in Colombia. Mención de responsabilidad : Mateo Ceballos, Luis Esteban Orozco, Carlos Oliver Valderrama, Diana Isabel Londoño, Luz Helena Lugo Referencia : Ann Vasc Surg. 2017 Apr;40:327-334. DOI (Digital Object Identifier) : 10.1016/j.avsg.2016.07.090 PMID : 27903479 En línea : https://linkinghub.elsevier.com/retrieve/pii/S0890-5096(16)31245-6 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4086 Reserva
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