Bedside versus operating room tracheostomy: A cost-effectiveness and economic evaluation

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-03-25 DOI:10.1016/j.amjsurg.2025.116314

William Yu Luo , Jaclyn Portelli Tremont , Sachi Vivek Shinde , Michael Ryan Phillips , Pascal Osita Udekwu , Anthony Charles

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引用次数: 0

Abstract

Background

Prior studies have compared outcomes and costs between bedside tracheostomy (BT) and operating room tracheostomy (ORT). However, studies have not performed a formal cost-effectiveness analysis of BT versus ORT.

Methods

We present a cost-effectiveness study using Markov microsimulation for BT versus ORT. We abstracted model parameters from currently available literature and performed deterministic and probabilistic sensitivity analyses.

Results

BT was more cost-effective than ORT at a $100,000/quality-adjusted life year willingness to pay (WTP) threshold. Our model was sensitive to postoperative pneumonia rates and pneumonia treatment costs. BT was more cost-effective in most iterations within a range of WTP thresholds from $0 to $200,000.

Conclusions

BT is more cost-effective than ORT for critically ill patients at low-average risk for postoperative pneumonia. Our findings support considering bedside tracheostomy before performing the same procedure in the operating room, regardless of whether the approach is percutaneous or open.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.