Evidence map›Paper›PMID 39109276›Full record

ArticleJournal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures)2024

Ventilator-Associated Events Cost in ICU Patients Receiving Mechanical Ventilation: A Multi-State Model.

Alkmena Kafazi, Eleni Apostolopoulou, Vasiliki Benetou, Georgia Kourlaba, Christos Stylianou, Ioanna D Pavlopoulou

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Article in Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Alkmena KafaziFaculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece.
Eleni ApostolopoulouFaculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece.
Vasiliki BenetouMedical School, National and Kapodistrian University of Athens, Athens, Greece.
Georgia KourlabaDepartment of Nursing, University of Peloponnese, Tripoli, Greece.
Christos StylianouThe 417 Army Equity Fund Hospital, Athens, Greece.
Ioanna D PavlopoulouFaculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Cost analysis is complicated by the fact that patients acquire infections during their hospital stay, having already spent time at risk without having an infection. Multi-state models (MSM) accounts for this time at risk treating infections as time-dependent exposures from ICU admission. Aim of the study: To estimate ventilator-associated events (VAEs) direct additional cost in ICU patients. Material and Methods: This was a prospective, observational study carried out for a two-year period in four medical-surgical ICUs of Athens, Greece. The sample consisted of adult patients who received mechanical ventilation for ≥4 days and were followed until discharge from the ICU or until death. CDC standard definitions were used to diagnose VAEs. To estimate VAEs additional length of stay (LOS), we used a four-state model that accounted for the time of VAEs. The direct hospital cost was calculated, consisting of the fixed and variable cost. The direct additional cost per VAEs episode was calculated by multiplying VAEs extra LOS by cost per day of ICU hospitalization. Results: In the final analysis were included 378 patients with 9,369 patient-days. The majority of patients were male (58.7%) with a median age of 60 years. Of 378 patients 143 (37.8%) developed 143 episodes of VAEs. VAEs crude additional LOS was 17 days, while VAE mean additional LOS after applying MSM was 6.55±1.78 days. The direct cost per day of ICU hospitalization was € 492.80. The direct additional cost per VAEs episode was € 3,227.84, € 885.56 the fixed and € 2,342.28 the variable cost. Antibiotic cost was € 1,570.95 per VAEs episode. The total direct additional cost for the two-year period was € 461,581.12. Conclusions: These results confirm the importance of estimating VAEs real cost using micro-costing for analytical cost allocation, and MSM to avoid additional LOS and cost overestimation.

Indexed as

costintensive care unitsmechanical ventilationmulti-state modelventilator-associated events

Identifiers

PMID39109276
PMCPMC11193978

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