دورية أكاديمية
أعرض في EDS

Cost effectiveness of a 1-hour high-sensitivity troponin-T protocol: An analysis of the RAPID-TnT trial.

التفاصيل البيبلوغرافية
العنوان: Cost effectiveness of a 1-hour high-sensitivity troponin-T protocol: An analysis of the RAPID-TnT trial.
المؤلفون: Chuang MA; College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia.; South Australian Department of Health, Adelaide, Australia., Gnanamanickam ES; College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia.; South Australian Department of Health, Adelaide, Australia., Karnon J; College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia., Lambrakis K; College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia.; South Australian Department of Health, Adelaide, Australia., Horsfall M; South Australian Department of Health, Adelaide, Australia., Blyth A; College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia.; South Australian Department of Health, Adelaide, Australia., Seshadri A; College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia.; South Australian Department of Health, Adelaide, Australia., Nguyen MT; College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia.; South Australian Department of Health, Adelaide, Australia., Briffa T; School of Population and Global Health, University of Western Australia, Perth, Australia., Cullen LA; School of Medicine, University of Adelaide, Adelaide, Australia.; Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia., Quinn S; Department of Health Science and Biostatistics, Swinburne University of Technology, Melbourne, Australia., French JK; Department of Cardiology, Liverpool Hospital, University of New South Wales, Sydney, Australia., Chew DP; College of Medicine & Public Health, Flinders University of South Australia, Adelaide, Australia.; South Australian Department of Health, Adelaide, Australia.
المصدر: International journal of cardiology. Heart & vasculature [Int J Cardiol Heart Vasc] 2021 Dec 29; Vol. 38, pp. 100933. Date of Electronic Publication: 2021 Dec 29 (Print Publication: 2022).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Ireland Ltd Country of Publication: Ireland NLM ID: 101649525 Publication Model: eCollection Cited Medium: Print ISSN: 2352-9067 (Print) Linking ISSN: 23529067 NLM ISO Abbreviation: Int J Cardiol Heart Vasc Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Shannon [Ireland] : Elsevier Ireland Ltd., [2014]-
مستخلص: Background: To understand the economic impact of an accelerated 0/1-hour high-sensitivity troponin-T (hs-cTnT) protocol.
Objective: To conduct a patient-level economic analysis of the RAPID-TnT randomised trial in patients presenting with suspected acute coronary syndrome (ACS).
Methods: An economic evaluation was conducted with 3265 patients randomised to either the 0/1-hour hs-cTnT protocol (n = 1634) or the conventional 0/3-hour standard-of-care protocol (n = 1631) with costs reported in Australian dollars. The primary clinical outcome was all-cause mortality or new/recurrent myocardial infarction.
Results: Over 12-months, mean per patient costs were numerically higher in the 0/1-hour arm compared to the conventional 0/3-hour arm (by $472.49/patient, 95% confidence interval [95 %CI]: $-1,380.15 to $2,325.13, P = 0.617) with no statistically significant difference in primary outcome (0/1-hour: 62/1634 [3.8%], 0/3-hour: 82/1631 [5.0%], HR: 1.32 [95 %CI: 0.95-1.83], P = 0.100). The mean emergency department (ED) length of stay (LOS) was significantly lower in the 0/1-hour arm (by 0.62 h/patient, 95 %CI: 0.85 to 0.39, P < 0.001), but the subsequent 12-month unplanned inpatient costs was numerically higher (by $891.22/patient, 95 %CI: $-96.07 to 1,878.50, P = 0.077). Restricting the analysis to patients with hs-cTnT concentrations ≤ 29 ng/L, mean per patient cost remained numerically higher in the 0/1-hour arm (by $152.44/patient, 95 %CI:$-1,793.11 to $2,097.99, P = 0.988), whilst the reduction in ED LOS was more pronounced (by 0.70 h/patient, 95 %CI: 0.45-0.95, P < 0.001).
Conclusions: There were no differences in resource utilization between the 0/1-hour hs-cTnT protocol versus the conventional 0/3-hour protocol for the assessment of suspected ACS, despite improved initial ED efficiency. Further refinements in strategies to improve clinical outcomes and subsequent management efficiency are needed.
Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(© 2021 Published by Elsevier B.V.)
التعليقات: Comment in: Int J Cardiol Heart Vasc. 2022 Feb 02;39:100963. (PMID: 35146120)
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فهرسة مساهمة: Keywords: Acute coronary syndrome; Cost-effectiveness; High-sensitivity troponin; RAPID TnT; Randomised trial
تواريخ الأحداث: Date Created: 20220113 Latest Revision: 20220430
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC8728427
DOI: 10.1016/j.ijcha.2021.100933
PMID: 35024428
قاعدة البيانات: MEDLINE
الوصف
تدمد:2352-9067
DOI:10.1016/j.ijcha.2021.100933