TY - JOUR
T1 - 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
AU - NIHR Global Health Research Unit on Global Surgery
AU - GlobalSurg Collaborative
AU - NIHR Global Health Research Unit on Global Surgery Writing committee
AU - GlobalSurg Collaborative writing group
AU - GlobalSurg Collaborative patient representatives
AU - Protocol development
AU - GlobalSurg Collaborative national leads
AU - GlobalSurg Collaborative protocol translators
AU - Kachapila, Mwayi
AU - Monahan, Mark
AU - Ademuyiwa, Adesoji O.
AU - Adinoyi, Yakubu Momohsani
AU - Biccard, Bruce M.
AU - George, Christina
AU - Ghosh, Dhruva N.
AU - Glasbey, James
AU - Morton, Dion G.
AU - Osayomwanbo, Osaheni
AU - Pearse, Rupert
AU - Roberts, Tracy E.
AU - Suroy, Atul
AU - Yakubu, Saidu Yusuf
AU - Oppong, Raymond
AU - Bhangu, Aneel
AU - Aguilera, Maria Lorena
AU - Alexander, Philip
AU - Al-Saqqa, Sara W.
AU - Borda-Luque, Giuliano
AU - Costas-Chavarri, Ainhoa
AU - Drake, Thomas M.
AU - Ntirenganya, Faustin
AU - Fitzgerald, J. Edward
AU - Fergusson, Stuart J.
AU - Ingabire, J. C.Allen
AU - Ismaïl, Lawani
AU - Salem, Hosni Khairy
AU - Teddy Kojo, Anyomih Theophilus
AU - Lapitan, Marie Carmela
AU - Lilford, Richard
AU - Mihaljevic, Andre L.
AU - Morton, Dion
AU - Mutabazi, Alphonse Zeta
AU - Nepogodiev, Dmitri
AU - Adisa, Adewale O.
AU - Ots, Riinu
AU - Pata, Francesco
AU - Pinkney, Thomas
AU - Poškus, Tomas
AU - Qureshi, Ahmad Uzair
AU - Ramos-De la Medina, Antonio
AU - Rayne, Sarah
AU - Shaw, Catherine A.
AU - Shu, Sebastian
AU - Spence, Richard
AU - Smart, Neil
AU - Adu-Aryee, Niiarmah
AU - Bediako-Bowan, Antoinette
AU - Dedey, Florence
N1 - Publisher Copyright:
© 2023 The Authors
PY - 2023/9
Y1 - 2023/9
N2 - Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, 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 ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was $216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with $195 for low FiO2 leading to a −$11 (95% CI: −$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was $1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this.
AB - Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was $216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with $195 for low FiO2 leading to a −$11 (95% CI: −$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was $1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this.
KW - abdominal surgery
KW - cost-effectiveness analysis
KW - global surgery
KW - high fraction of inspired oxygen
KW - low-and middle-income countries
KW - surgical site infection
UR - https://www.scopus.com/pages/publications/85181384108
U2 - 10.1016/j.bjao.2023.100207
DO - 10.1016/j.bjao.2023.100207
M3 - Article
AN - SCOPUS:85181384108
SN - 2772-6096
VL - 7
JO - BJA Open
JF - BJA Open
M1 - 100207
ER -