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Cost effectiveness of local collagen-gentamicin as prophylaxis for sternal wound infections in different risk groups

Friberg, Örjan (author)
Linköpings universitet,Thoraxkirurgi,Hälsouniversitetet
Dahlin, Lars-Göran (author)
Linköpings universitet,Thoraxkirurgi,Hälsouniversitetet
Levin, Lars-Åke (author)
Linköpings universitet,Utvärdering och hälsoekonomi,Hälsouniversitetet
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Magnusson, Anders (author)
Unit of Statistics, Centre for Clinical Research, Örebro University Hospital, Örebro, Sweden
Granfeldt, Hans (author)
Linköpings universitet,Thoraxkirurgi,Hälsouniversitetet
Källman, Jan (author)
Örebro universitet,Institutionen för klinisk medicin,Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden
Svedjeholm, Rolf (author)
Linköpings universitet,Thoraxkirurgi,Hälsouniversitetet
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 (creator_code:org_t)
2009-08-26
2006
English.
In: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 40:2, s. 117-125
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • OBJECTIVES: In a randomized trial addition of local collagen-gentamicin in the sternal wound reduced the rate of sternal wound infection (SWI) to about 50% compared to intravenous prophylaxis alone. The aim of the present study was to evaluate the economic rationale for its use in every-day clinical practice. This includes the question whether high-risk groups that may have particular benefit should be identified. DESIGN: For each patient with SWI in the trial the costs attributable to the SWI were calculated. Risk factors for SWI were identified and any heterogeneity of the effect of the prophylaxis examined. RESULTS: The mean cost of a SWI was about 14500 Euros. A cost effectiveness analysis showed that the prophylaxis was cost saving. The positive net balance was even higher in risk groups. Assignment to the control group, overweight, diabetes, younger age, mammarian artery use, left ventricular ejection fraction <35% and longer operation time were independent risk factors for infection. CONCLUSION: The addition of local collagen-gentamicin to intravenous antibiotic prophylaxis was dominant, i.e. resulted in both lower costs and fewer wound infections.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Infectious Medicine (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Keyword

MEDICINE
MEDICIN
Infectious diseases
Infektionssjukdomar
Thoracic surgery
Thoraxkirurgi
Medicine
Medicin
Cardiac Surgery; Cardiology

Publication and Content Type

ref (subject category)
art (subject category)

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