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The Cost-Effectiveness of Silver-Impregnated Occlusive Dressings for Infection Prevention After Total Joint Arthroplasty
- Source :
- The Journal of Arthroplasty. 36:1753-1757
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Background Prosthetic joint infection (PJI) is a catastrophic complication after total joint arthroplasty that exacts a substantial economic burden on the health-care system. This study used break-even analysis to investigate whether the use of silver-impregnated occlusive dressings is a cost-effective measure for preventing PJI after primary total knee arthroplasty (TKA) and total hip arthroplasty (THA). Methods Baseline infection rates after TKA and THA, the cost of revision arthroplasty for PJI, and the cost of a silver-impregnated occlusive dressing were determined based on institutional data and the existing literature. A break-even analysis was then conducted to calculate the minimal absolute risk reduction needed for cost-effectiveness. Results The use of silver-impregnated occlusive dressings would be economically viable at an infection rate of 1.10%, treatment costs of $25,692 for TKA PJI, and $31,753 for THA PJI and our institutional dressing price of $38.05 if it reduces infection rates after TKA by 0.15% (the number needed to treat [NNT] = 676) and THA by 0.12% (NNT = 835). The absolute risk reduction needed to maintain cost-effectiveness did not change with varying initial infection rates and remained less than 0.40% (NNT = 263) for infection treatment costs as low as $10,000 and less than 0.80% (NNT = 129) for dressing prices as high as $200. Conclusion The use of silver-impregnated occlusive dressings is a cost-effective measure for infection prophylaxis after TKA and THA.
- Subjects :
- musculoskeletal diseases
medicine.medical_specialty
Prosthesis-Related Infections
Silver
Joint arthroplasty
Cost effectiveness
Arthroplasty, Replacement, Hip
Cost-Benefit Analysis
Occlusive Dressings
03 medical and health sciences
0302 clinical medicine
Humans
Medicine
Infection control
Orthopedics and Sports Medicine
health care economics and organizations
030222 orthopedics
business.industry
Absolute risk reduction
musculoskeletal system
Surgery
Occlusive dressing
surgical procedures, operative
Number needed to treat
business
Complication
Total hip arthroplasty
Subjects
Details
- ISSN :
- 08835403
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- The Journal of Arthroplasty
- Accession number :
- edsair.doi.dedup.....aac5254f480cfcb5bd5e80b19d941180