中心静脉导管切除后常规X射线的成本效益:对切除后并发症的基于价值的分析
Martin Breitwieser1, Teresa Wiesner1, Vanessa Moore1
1Department for Orthopedic Surgery and Traumatology, Paracelsus Medical University, 5020 Salzburg, Austria.
Journal of clinical medicine
|February 26, 2025
概括
对于中央静脉导管 (CVCs) 的常规切除后胸部X射线是昂贵的,很少检测并发症. 基于症状的方法对患者来说更具成本效益和安全性.
科学领域:
- 医疗保健经济学 医疗保健经济学
- 医学成像医学成像
- 干预程序是干预程序.
背景情况:
- 随着医疗保健成本的上升,需要有效地分配资源.
- 成本效益分析 (CEA) 对于评估医疗干预至关重要.
- 对于中央静脉导管 (CVC) 的常规切除后胸部X射线缺乏证据,但由于误解而持续存在.
研究的目的:
- 分析常规的切除后心脏内脏成像的成本效益.
- 评估与CVC切除相关的并发症检测率.
- 挑战常规切除后CVC成像的必要性,并促进基于证据的实践.
主要方法:
- 在奥地利四所大学医院 (2012-2021) 进行了984次CVC移除的回顾性队列分析.
- 每项结果成本分析使用基于活动的成本计算,调整到2024年的价格水平.
- 插入后X射线与移除后X射线的比较,以确定CVC移除特定并发症.
主要成果:
- 在0.5%的病例中 (n=5) 发生了CVC切除并发症.
- 常规的X射线检查费用为37,588.80欧元,984次移除,检测并发症每次7517.76欧元.
- 在有症状的患者中发现并发症的可能性是193倍 (p < 0.001).
结论:
- 在无症状患者中,常规的切除后CVCX射线在临床上没有益处.
- 基于症状的成像策略更具成本效益,并减少辐射暴露.
- 实施基于证据的成像协议优化了CVC移除的资源配置.
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