作者
Nicholas Graves, Catherine Wloch, Jennie Wilson, Adrian Barnett, Alex Sutton, Nicola Cooper, Katharina Merollini, Victoria McCreanor, Qinglu Cheng, Edward Burn, Theresa Lamagni, Andre Charlett
发表日期
2016/7/1
来源
Health Technology Assessment
简介
© Queen’s Printer and Controller of HMSO 2016.
Background
A deep infection of the surgical site is reported in 0.7% of all cases of total hip arthroplasty (THA). This often leads to revision surgery that is invasive, painful and costly. A range of strategies is employed in NHS hospitals to reduce risk, yet no economic analysis has been undertaken to compare the value for money of competing prevention strategies.
Objectives
To compare the costs and health benefits of strategies that reduce the risk of deep infection following THA in NHS hospitals. To make recommendations to decision-makers about the cost-effectiveness of the alternatives.
Design
The study comprised a systematic review and cost-effectiveness decision analysis.
Setting
77,321 patients who had a primary hip arthroplasty in NHS hospitals in 2012.
Interventions
Nine different treatment strategies including antibiotic prophylaxis, antibiotic-impregnated cement and ventilation systems used in the operating theatre.
Main outcome measures
Change in the number of deep infections, change in the total costs and change in the total health benefits in quality-adjusted life-years (QALYs).
Data sources
Literature searches using MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature and the Cochrane Central Register of Controlled Trials were undertaken to cover the period 1966-2012 to identify infection prevention strategies. Relevant journals, conference proceedings and bibliographies of retrieved papers were hand-searched. Orthopaedic surgeons and infection prevention experts were also consulted.
Review methods
English-language papers only. The selection of …
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