Surgery and adjuvant therapy in patients with diffuse peritonitis: cost analysis.

Area of Science:

• Critical Care Medicine
• Surgical Infections
• Health Economics

Background:

• Diffuse secondary peritonitis presents significant treatment challenges and high costs.
• Intensive care unit (ICU) management is a major cost driver in peritonitis treatment.
• Optimizing treatment strategies is crucial for improving patient outcomes and reducing healthcare expenditure.

Purpose of the Study:

• To evaluate the clinical and economic impact of high-dose intravenous antithrombin III (AT-III) and intraabdominal donor serum in patients with diffuse secondary peritonitis.
• To assess the cost-effectiveness of adjuvant therapy in managing peritonitis.
• To analyze the impact on quality of life and resource utilization.

Main Methods:

• Prospective, randomized, controlled trial involving 36 patients with diffuse secondary peritonitis.
• Analysis of direct treatment costs, including intensive care, operating theater, and general ward expenditures.
• Assessment of quality of life using the gastrointestinal quality of life index (GIQI) and calculation of cost per Quality Adjusted Life Year (QALY).

Main Results:

• Adjuvant therapy, including AT-III, was associated with reduced ICU treatment duration, mechanical respiration time, and hemofiltration.
• Treatment costs were reduced by 6614 euros per patient with adjuvant therapy.
• Despite an additional cost of 5155 euros for AT-III, overall treatment costs were significantly offset by savings.
• Good quality of life outcomes were observed, with an average of 11 QALYs achieved at a cost of 2361 euros per QALY.

Conclusions:

• High-dose intravenous antithrombin III as adjuvant therapy is a cost-effective strategy for managing diffuse secondary peritonitis.
• Adjuvant therapy leads to significant reductions in resource utilization and healthcare costs.
• The use of AT-III in peritonitis treatment improves patient outcomes and quality of life while being economically viable.