2023-09-25 ペンシルベニア州立大学(PennState)
A new blood test could prevent some of the 350,000 sepsis deaths in the U.S. each year, according to new research from an interdisciplinary team of researchers. Credit: YakobchukOlena/Getty Images. All Rights Reserved.
◆ペンシルベニア州立大学の研究によれば、敗血症の新しい血液検査は命と費用を節約できる可能性があるとされています。この新しいテストは、患者の白血球の変化を特徴づけ、敗血症の高リスクの患者を迅速に評価します。
◆研究者は、このテストの病院の緊急部門での使用に関する経済モデルを作成し、テストの使用によるコストと利益を評価しました。この研究は、テストの使用により、敗血症の患者の診断が正確に行われることで、多くの人命が救われる可能性があることを示しています。
<関連情報>
- https://www.psu.edu/news/health-and-human-development/story/new-test-sepsis-could-save-lives-emergency-departments-study/
- https://journals.lww.com/ccejournal/fulltext/2023/07000/costs_and_consequences_of_a_novel_emergency.14.aspx
新しい救急部敗血症診断検査のコストと結果: インテリセップ指数 Costs and Consequences of a Novel Emergency Department Sepsis Diagnostic Test: The IntelliSep Index
Hollenbeak, Christopher S. Henning, Daniel J. Geeting, Glenn K. Ledeboer, Nathan A. Faruqi, Imran A. Pierce, Christi G. Thomas, Christopher B. Hollis R. Jr
Critical Care Explorations Published:July 2023.
DOI: 10.1097/CCE.0000000000000942
Abstract
OBJECTIVES:
Sepsis causes 270,000 deaths and costs $38 billion annually in the United States. Most cases of sepsis present in the emergency department (ED), where rapid diagnosis remains challenging. The IntelliSep Index (ISI) is a novel diagnostic test that analyzes characteristics of WBC structure and provides a reliable early signal for sepsis. This study performs a cost-consequence analysis of the ISI relative to procalcitonin for early sepsis diagnosis in the ED.
PERSPECTIVE:
U.S. healthcare system.
SETTING:
Community hospital ED.
METHODS:
A decision tree analysis was performed comparing ISI with procalcitonin. Model parameters included prevalence of sepsis, sensitivity and specificity of diagnostic tests (both ISI and procalcitonin), costs of hospitalization, and mortality rate stratified by diagnostic test result. Mortality and prevalence of sepsis were estimated from best available literature. Costs were estimated based on an analysis of a large, national discharge dataset, and adjusted to 2018 U.S. dollars. Outcomes included expected costs and survival.
RESULTS:
Assuming a confirmed sepsis prevalence of 16.9% (adjudicated to Sepsis-3), the ISI strategy had an expected cost per patient of $3,849 and expected survival rate of 95.08%, whereas the procalcitonin strategy had an expected cost of $4,656 per patient and an expected survival of 94.98%. ISI was both less costly and more effective than procalcitonin, primarily because of fewer false-negative results. These results were robust in sensitivity analyses.
CONCLUSIONS:
ISI was both less costly and more effective in preventing mortality than procalcitonin, primarily because of fewer false-negative results. The ISI may provide health systems with a higher-value diagnostic test in ED sepsis evaluation. Additional work is needed to validate these results in clinical practice.
