Cost-Effectiveness Analysis of the Use of a Prophylactic Antibiotic for Patients Undergoing Lower Limb Amputation due to Diabetes or Vascular Illness in Colombia

Mateo Ceballos, Luis Esteban Orozco, Carlos Oliver Valderrama, Diana Isabel Londoño, Luz Helena Lugo

Resultado de la investigación: Contribución a RevistaArtículo de revisión

1 Cita (Scopus)

Resumen

Background: The use of a prophylactic antibiotic in an amputation surgery is a key element for
the successful recovery of the patient. We aim to determine, from the perspective of the Colombian
health system, the cost-effectiveness of administering a prophylactic antibiotic among patients
undergoing lower limb amputation due to diabetes or vascular illness in Colombia.
Methods: A decision tree was constructed to compare the use and nonuse of a prophylactic
antibiotic. The probabilities of transition were obtained from studies identified from a systematic
review of the clinical literature. The chosen health outcome was reduction in mortality due to prevention
of infection. The costs were measured by expert consensus using the standard case
methodology, and the resource valuation was carried out using national-level pricing manuals.
Deterministic sensitivity, scenarios, and probabilistic analyses were conducted.
Results: In the base case, the use of a prophylactic antibiotic compared with nonuse was a
dominant strategy. This result was consistent when considering different types of medications
and when modifying most of the variables in the model. The use of a prophylactic antibiotic
ceases to be dominant when the probability of infection is greater than 48%.
Conclusions: The administration of a prophylactic antibiotic was a dominant strategy, which is
a conclusion that holds in most cases examined; therefore, it is unlikely that the uncertainty
around the estimation of costs and benefits change the results. We recommend creating policies
oriented toward promoting the use of a prophylactic antibiotic during amputation surgery in
Colombia.
Idioma originalEnglish (US)
Páginas (desde-hasta)327-334
Número de páginas8
PublicaciónAnnals of Vascular Surgery
Volumen40
DOI
EstadoPublished - abr 1 2017
Publicado de forma externa

Huella dactilar

Colombia
Amputation
Cost-Benefit Analysis
Blood Vessels
Lower Extremity
Anti-Bacterial Agents
Costs and Cost Analysis
Decision Trees
Infection
Health Care Costs
Uncertainty
Mortality
Health

All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine

Citar esto

Ceballos, Mateo ; Orozco, Luis Esteban ; Valderrama, Carlos Oliver ; Londoño, Diana Isabel ; Lugo, Luz Helena. / Cost-Effectiveness Analysis of the Use of a Prophylactic Antibiotic for Patients Undergoing Lower Limb Amputation due to Diabetes or Vascular Illness in Colombia. En: Annals of Vascular Surgery. 2017 ; Vol. 40. pp. 327-334.
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title = "Cost-Effectiveness Analysis of the Use of a Prophylactic Antibiotic for Patients Undergoing Lower Limb Amputation due to Diabetes or Vascular Illness in Colombia",
abstract = "Background The use of a prophylactic antibiotic in an amputation surgery is a key element for the successful recovery of the patient. We aim to determine, from the perspective of the Colombian health system, the cost-effectiveness of administering a prophylactic antibiotic among patients undergoing lower limb amputation due to diabetes or vascular illness in Colombia. Methods A decision tree was constructed to compare the use and nonuse of a prophylactic antibiotic. The probabilities of transition were obtained from studies identified from a systematic review of the clinical literature. The chosen health outcome was reduction in mortality due to prevention of infection. The costs were measured by expert consensus using the standard case methodology, and the resource valuation was carried out using national-level pricing manuals. Deterministic sensitivity, scenarios, and probabilistic analyses were conducted. Results In the base case, the use of a prophylactic antibiotic compared with nonuse was a dominant strategy. This result was consistent when considering different types of medications and when modifying most of the variables in the model. The use of a prophylactic antibiotic ceases to be dominant when the probability of infection is greater than 48{\%}. Conclusions The administration of a prophylactic antibiotic was a dominant strategy, which is a conclusion that holds in most cases examined; therefore, it is unlikely that the uncertainty around the estimation of costs and benefits change the results. We recommend creating policies oriented toward promoting the use of a prophylactic antibiotic during amputation surgery in Colombia.",
author = "Mateo Ceballos and Orozco, {Luis Esteban} and Valderrama, {Carlos Oliver} and Londo{\~n}o, {Diana Isabel} and Lugo, {Luz Helena}",
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Cost-Effectiveness Analysis of the Use of a Prophylactic Antibiotic for Patients Undergoing Lower Limb Amputation due to Diabetes or Vascular Illness in Colombia. / Ceballos, Mateo; Orozco, Luis Esteban; Valderrama, Carlos Oliver; Londoño, Diana Isabel; Lugo, Luz Helena.

En: Annals of Vascular Surgery, Vol. 40, 01.04.2017, p. 327-334.

Resultado de la investigación: Contribución a RevistaArtículo de revisión

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T1 - Cost-Effectiveness Analysis of the Use of a Prophylactic Antibiotic for Patients Undergoing Lower Limb Amputation due to Diabetes or Vascular Illness in Colombia

AU - Ceballos, Mateo

AU - Orozco, Luis Esteban

AU - Valderrama, Carlos Oliver

AU - Londoño, Diana Isabel

AU - Lugo, Luz Helena

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Y1 - 2017/4/1

N2 - Background The use of a prophylactic antibiotic in an amputation surgery is a key element for the successful recovery of the patient. We aim to determine, from the perspective of the Colombian health system, the cost-effectiveness of administering a prophylactic antibiotic among patients undergoing lower limb amputation due to diabetes or vascular illness in Colombia. Methods A decision tree was constructed to compare the use and nonuse of a prophylactic antibiotic. The probabilities of transition were obtained from studies identified from a systematic review of the clinical literature. The chosen health outcome was reduction in mortality due to prevention of infection. The costs were measured by expert consensus using the standard case methodology, and the resource valuation was carried out using national-level pricing manuals. Deterministic sensitivity, scenarios, and probabilistic analyses were conducted. Results In the base case, the use of a prophylactic antibiotic compared with nonuse was a dominant strategy. This result was consistent when considering different types of medications and when modifying most of the variables in the model. The use of a prophylactic antibiotic ceases to be dominant when the probability of infection is greater than 48%. Conclusions The administration of a prophylactic antibiotic was a dominant strategy, which is a conclusion that holds in most cases examined; therefore, it is unlikely that the uncertainty around the estimation of costs and benefits change the results. We recommend creating policies oriented toward promoting the use of a prophylactic antibiotic during amputation surgery in Colombia.

AB - Background The use of a prophylactic antibiotic in an amputation surgery is a key element for the successful recovery of the patient. We aim to determine, from the perspective of the Colombian health system, the cost-effectiveness of administering a prophylactic antibiotic among patients undergoing lower limb amputation due to diabetes or vascular illness in Colombia. Methods A decision tree was constructed to compare the use and nonuse of a prophylactic antibiotic. The probabilities of transition were obtained from studies identified from a systematic review of the clinical literature. The chosen health outcome was reduction in mortality due to prevention of infection. The costs were measured by expert consensus using the standard case methodology, and the resource valuation was carried out using national-level pricing manuals. Deterministic sensitivity, scenarios, and probabilistic analyses were conducted. Results In the base case, the use of a prophylactic antibiotic compared with nonuse was a dominant strategy. This result was consistent when considering different types of medications and when modifying most of the variables in the model. The use of a prophylactic antibiotic ceases to be dominant when the probability of infection is greater than 48%. Conclusions The administration of a prophylactic antibiotic was a dominant strategy, which is a conclusion that holds in most cases examined; therefore, it is unlikely that the uncertainty around the estimation of costs and benefits change the results. We recommend creating policies oriented toward promoting the use of a prophylactic antibiotic during amputation surgery in Colombia.

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