Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share By
A Cost-Effectiveness Analysis of Albumin in Septic Shock: A Patient-Level Data Analysis Publisher Pubmed



Tigabu BM1, 2, 3 ; Davari M1, 2 ; Kebriaeezadeh A1, 2 ; Mojtahedzadeh M4, 5 ; Sadeghi K4 ; Najmeddin F4 ; Jahangardrafsanjani Z4
Authors

Source: Clinical Therapeutics Published:2019


Abstract

Purpose: Albumin-based fluid therapy in septic shock is a matter of debate and criticism. The aim of this study was to assess the cost-effectiveness of albumin therapy in patients with septic shock. Methods: A retrospective cohort study was conducted in Imam Khomeini, Sina, and Shariati hospitals on patients with septic shock admitted to intensive care units from March 31, 2016 to September 22, 2017. Data sources were the health information system database and patient medical records. The patients with potential septic shock were identified based on norepinephrine use. Septic shock was confirmed after medical record review based on systemic inflammatory response syndrome criteria, antibiotic use, and fluid therapy. Patients who received albumin in the fluid therapy were compared with patients treated without albumin. The 28-day mortality, life-year gain, and cost-effectiveness were evaluated. Findings: The addition of albumin had no significant increase in life-year gain (mean difference = 0.67; 95% CI, −2.25 to 3.58). However, the addition of albumin increased the total cost of treatment by US $3846.07 (95% CI, US $2093.46–US $5598.98). The incremental cost-effectiveness ratio calculated based on the mean life-years gained was US$5740.40 per a life-year gained. The net monetary benefit was negative (−355.4; 95% CI, −15,387.61 to 14,676.81), and the probability that the addition of albumin will be cost-effective at a gross domestic product per capita was 40.0%. Implications: Albumin-based fluid therapy does not improve the 28-day mortality of patients with septic shock. The addition of albumin in the fluid therapy of patients with septic shock was not cost-effective. Both the observational and retrospective nature of the study was expected to introduce bias. We recommend a cost-effectiveness analysis combined with clinical trials to settle the debate once and for all. © 2019
Other Related Docs
13. Effect of Hospital-Wide Interventions to Optimize Albumin Use in a Tertiary Hospital, Journal of Clinical Pharmacy and Therapeutics (2017)
14. Antibiotic Therapy in Sepsis: No Next Time for a Second Chance!, Journal of Clinical Pharmacy and Therapeutics (2021)