Treatment of the critically ill patient with protein C: Is it worth the cost?
(2010) In Thrombosis Research 125(6). p.494-500- Abstract
- INTRODUCTION: We have shown that low protein C levels predict poor survival up to five years in a general intensive care unit patient material and hypothesize that treatment with protein C is beneficial. The objectives were to calculate costs of protein C treatment, at best-case scenario, per statistical life saved. MATERIALS AND METHODS: Ninety-two patients with deranged global haemostatic tests admitted to the mixed surgical medical intensive care unit, Malmö University Hospital. We hypothesized that increasing protein C levels in patients with low levels would enhance survival to the same rate as a cohort with higher protein C. Number of statistical lives saved were estimated using survival analysis. Costs per life saved at 30days were... (More)
- INTRODUCTION: We have shown that low protein C levels predict poor survival up to five years in a general intensive care unit patient material and hypothesize that treatment with protein C is beneficial. The objectives were to calculate costs of protein C treatment, at best-case scenario, per statistical life saved. MATERIALS AND METHODS: Ninety-two patients with deranged global haemostatic tests admitted to the mixed surgical medical intensive care unit, Malmö University Hospital. We hypothesized that increasing protein C levels in patients with low levels would enhance survival to the same rate as a cohort with higher protein C. Number of statistical lives saved were estimated using survival analysis. Costs per life saved at 30days were calculated. RESULTS: Total costs per life saved in 2007 prices (upper limit of 95% CI) were calculated at euro 50,200 (recombinant activated protein C, drotrecogin alfa (activated), Xigris((R))) and euro 46,000 (zymogen protein C, Ceprotin), which may be compared to the value of a statistical life (euro 937,000). CONCLUSIONS: Our theoretical model of converting a low protein C group to a higher protein C group by treating with activated protein C or the protein zymogen showed no major difference between the treatments in terms of costs, and that costs are lower than the value of a statistical life. Although our study has several caveats the results support the PROWESS study, in that patients with a very severe disease, having low protein C levels, may benefit from protein C treatment in a cost effective way. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1500009
- author
- Nilsson, Gunnar LU ; Höjgård, Sören LU and Berntorp, Erik LU
- organization
- publishing date
- 2010
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Thrombosis Research
- volume
- 125
- issue
- 6
- pages
- 494 - 500
- publisher
- Elsevier
- external identifiers
-
- wos:000278026400004
- pmid:19854472
- scopus:77952553093
- ISSN
- 1879-2472
- DOI
- 10.1016/j.thromres.2009.09.008
- language
- English
- LU publication?
- yes
- additional info
- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Anaesthesiology and Intensive Care (Mö) (013241110), Division of Health Economics and Forensic Medicine (Closed 2012) (013040050), Clinical Coagulation Research Unit (013242510)
- id
- be88347f-332f-4a9c-b15c-d46e5cbb4a2b (old id 1500009)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/19854472?dopt=Abstract
- date added to LUP
- 2016-04-01 11:03:12
- date last changed
- 2022-01-26 04:59:35
@article{be88347f-332f-4a9c-b15c-d46e5cbb4a2b, abstract = {{INTRODUCTION: We have shown that low protein C levels predict poor survival up to five years in a general intensive care unit patient material and hypothesize that treatment with protein C is beneficial. The objectives were to calculate costs of protein C treatment, at best-case scenario, per statistical life saved. MATERIALS AND METHODS: Ninety-two patients with deranged global haemostatic tests admitted to the mixed surgical medical intensive care unit, Malmö University Hospital. We hypothesized that increasing protein C levels in patients with low levels would enhance survival to the same rate as a cohort with higher protein C. Number of statistical lives saved were estimated using survival analysis. Costs per life saved at 30days were calculated. RESULTS: Total costs per life saved in 2007 prices (upper limit of 95% CI) were calculated at euro 50,200 (recombinant activated protein C, drotrecogin alfa (activated), Xigris((R))) and euro 46,000 (zymogen protein C, Ceprotin), which may be compared to the value of a statistical life (euro 937,000). CONCLUSIONS: Our theoretical model of converting a low protein C group to a higher protein C group by treating with activated protein C or the protein zymogen showed no major difference between the treatments in terms of costs, and that costs are lower than the value of a statistical life. Although our study has several caveats the results support the PROWESS study, in that patients with a very severe disease, having low protein C levels, may benefit from protein C treatment in a cost effective way.}}, author = {{Nilsson, Gunnar and Höjgård, Sören and Berntorp, Erik}}, issn = {{1879-2472}}, language = {{eng}}, number = {{6}}, pages = {{494--500}}, publisher = {{Elsevier}}, series = {{Thrombosis Research}}, title = {{Treatment of the critically ill patient with protein C: Is it worth the cost?}}, url = {{https://lup.lub.lu.se/search/files/2342016/1710475.pdf}}, doi = {{10.1016/j.thromres.2009.09.008}}, volume = {{125}}, year = {{2010}}, }