Cost-effectiveness analysis of emergency endoscopic variceal ligation plus octreotide in the treatment of acute esophageal variceal bleeding in cirrhotic patients / 中华流行病学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To compare and evaluate the cost and effectiveness of endoscopic variceal ligation (EVL) at emergency plus octreotide versus octreotide alone in the treatment of acute esophageal variceal bleeding in cirrhotic patients.</p><p><b>METHODS</b>Seventy-eight patients with active variceal bleeding under emergency endoscope, were assigned to two groups receiving either combined therapy of EVL at emergency and octreotide ('EVL' group) or a continuous infusion of octreotide alone ('octreotide' group). Both efficacy and cost-effectiveness were observed.</p><p><b>RESULTS</b>There were no significant differences between the two groups in patients' characteristics, supporting treatment or general treatment. In group EVL, there appeared a significantly higher rate in controlling bleeding and lower complication rate than that of octreotide group(94.4% vs.78.6%, P = 0.045 and 19.4% vs. 42.9%, P = 0.027, respectively). Early rebleeding and mortality rate were also lower in group EVL, but with no significant differences between them (2.9% vs. 7.7%, P = 0.358 and 5.6% vs. 14.3%, P = 0.205, respectively). The combined therapy had a significantly shorter time of hemostasis, less administration of octreoid, fewer units of blood transfusion and shorter hospital stay (P < 0.001). The median costs of the combined therapy and octreotide alone were RMB 9046.5 Yuan and 13 743.6 Yuan,respectively (P = 0.045). The cost-effective ratio of group EVL seemed superior to that of octreoid group.</p><p><b>CONCLUSION</b>The therapeutic scheme of emergency EVL plus octreotide was a more cost-effective one for controlling acute esophageal variceal bleeding.</p>