دورية أكاديمية
أعرض في EDS

The Cost-Effectiveness of Smoking Cessation Programs for Prevention of Wound Complications Following Total Ankle Arthroplasty: A Break-Even Analysis.

التفاصيل البيبلوغرافية
العنوان: The Cost-Effectiveness of Smoking Cessation Programs for Prevention of Wound Complications Following Total Ankle Arthroplasty: A Break-Even Analysis.
المؤلفون: Kim AH; Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA., ElNemer W; Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA., Cartagena-Reyes MA; Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA., Marrache M; Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA., Thompson JM; Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA., Aiyer AA; Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA.
المصدر: Foot & ankle orthopaedics [Foot Ankle Orthop] 2024 Mar 19; Vol. 9 (1), pp. 24730114241239315. Date of Electronic Publication: 2024 Mar 19 (Print Publication: 2024).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Sage Publications Country of Publication: United States NLM ID: 101752333 Publication Model: eCollection Cited Medium: Internet ISSN: 2473-0114 (Electronic) Linking ISSN: 24730114 NLM ISO Abbreviation: Foot Ankle Orthop Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Thousand Oaks, CA : Sage Publications, [2016]-
مستخلص: Background: Tobacco use significantly increases the rate of wound complications in patients undergoing total ankle arthroplasty (TAA). Preoperative optimization through smoking cessation programs significantly minimizes the rate of infection and improves wound healing in arthroplasty procedures. Despite its utility, minimal research has examined the cost-effectiveness of preoperative smoking cessation programs to reduce the need for extracapsular irrigation and debridement (I&D) due to wound complications following TAA.
Methods: The cost of an I&D procedure was obtained from our institution's purchasing records. Baseline wound complication rates among tobacco users who have undergone TAA and smoking cessation program cost were obtained from literature. A break-even economic analysis was performed to determine the absolute risk reduction (ARR) to economically justify the implementation of preoperative smoking cessation programs. Different smoking cessation program and I&D costs were tested to account for variations in each factor. ARR was then used to calculate the number needed to treat (NNT) to prevent a single I&D while remaining cost-effective.
Results: Smoking cessation programs were determined to be economically justified if it prevents 1 I&D surgery out of 8 TAAs among tobacco users (ARR = 12.66%) in the early postoperative period (<30 days). ARR was the same at the literature high (27.3%) and weighted literature average (13.3%) complication rates when using the cost of I&D surgery at our institution ($1757.13) and the literature value for a smoking cessation program ($222.45). Cost-effectiveness was maintained with higher I&D surgery costs and lower costs of smoking cessation treatment.
Conclusion: Our model's input data suggest that the routine use of smoking cessation programs among tobacco users undergoing TAA is cost-effective for risk reduction of I&D surgery in the early postoperative period. This intervention was also found to be economically warranted with higher I&D costs and lower smoking cessation program costs than those found in the literature and at our institution. Level of Evidence: Level III, economic and decision analysis.
Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Disclosure forms for all authors are available online.
(© The Author(s) 2024.)
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فهرسة مساهمة: Keywords: break-even analysis; cost-effectiveness; smoking cessation; total ankle arthroplasty; wound complications
تواريخ الأحداث: Date Created: 20240321 Latest Revision: 20240322
رمز التحديث: 20240322
مُعرف محوري في PubMed: PMC10952985
DOI: 10.1177/24730114241239315
PMID: 38510516
قاعدة البيانات: MEDLINE
الوصف
تدمد:2473-0114
DOI:10.1177/24730114241239315