Cost effectiveness and long-term outcomes of dexamethasone administration in major non-cardiac surgery.
J Clin Anesth
; 90: 111218, 2023 11.
Article
en En
| MEDLINE
| ID: mdl-37487337
ABSTRACT
STUDY OBJECTIVES:
Postoperative administration of dexamethasone has been proposed to reduce morbidity and mortality in patients undergoing major non-cardiac surgery. In this ancillary study of the PACMAN trial, we aimed to evaluate the cost effectiveness of dexamethasone in patients undergoing major non-cardiac surgery.METHODS:
Patients included in the multicentric randomized double-blind, placebo-controlled PACMAN trial were followed up for 12 months after their surgical procedure. Patients were randomized to receive either dexamethasone (0.2 mg/kg immediately after the surgical procedure, and on day 1) or placebo. Cost effectiveness between the dexamethasone and placebo groups was assessed for the 12-month postoperative period from a health payer perspective.RESULTS:
Of 1222 randomized patients in PACMAN, 137 patients (11%) were followed up until 12 months after major surgery (71 in the DXM group and 66 in the placebo group). Postoperative dexamethasone administration reduced costs per patient at 1 year by 358.06 (95%CI -1519.99 to 803.87). The probability of dexamethasone being cost effective was between 12% and 22% for a willingness to pay of 100,000 to 150,000 per life-year, which is the threshold that is usually used in France and was 52% for willingness to pay of 50,000 per life-year (threshold in USA). At 12 months, 9 patients (13.2%) in the DXM group and 10 patients (16.1%) in the placebo group had died. In conclusion, our study does not demonstrate the cost effectiveness of perioperative administration of DXM in major non-cardiac surgery.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_financiamento_saude
Asunto principal:
Dexametasona
/
Análisis de Costo-Efectividad
Tipo de estudio:
Clinical_trials
/
Health_economic_evaluation
Aspecto:
Patient_preference
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Clin Anesth
Asunto de la revista:
ANESTESIOLOGIA
Año:
2023
Tipo del documento:
Article