Details

Autor(en) / Beteiligte

• Treskes, K
• Sierink, J C
• Edwards, M J R
• Beuker, B J A
• Van Lieshout, E M M
• Hohmann, J
• Saltzherr, T P
• Hollmann, M W
• Van Dieren, S
• Goslings, J C
• Dijkgraaf, M G W

Titel

Cost-effectiveness of immediate total-body CT in patients with severe trauma (REACT-2 trial)

Ist Teil von

• British journal of surgery, 2021-04, Vol.108 (3), p.277-285

Ort / Verlag

England: Oxford University Press

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• The effect of immediate total-body CT (iTBCT) on health economic aspects in patients with severe trauma is an underreported issue. This study determined the cost-effectiveness of iTBCT compared with conventional radiological imaging with selective CT (standard work-up (STWU)) during the initial trauma evaluation. In this multicentre RCT, adult patients with a high suspicion of severe injury were randomized in-hospital to iTBCT or STWU. Hospital healthcare costs were determined for the first 6 months after the injury. The probability of iTBCT being cost-effective was calculated for various levels of willingness-to-pay per extra patient alive. A total of 928 Dutch patients with complete clinical follow-up were included. Mean costs of hospital care were €25 809 (95 per cent bias-corrected and accelerated (bca) c.i. €22 617 to €29 137) for the iTBCT group and €26 155 (€23 050 to €29 344) for the STWU group, a difference per patient in favour of iTBCT of €346 (€4987 to €4328) (P = 0.876). Proportions of patients alive at 6 months were not different. The proportion of patients alive without serious morbidity was 61.6 per cent in the iTBCT group versus 66.7 per cent in the STWU group (difference -5.1 per cent; P = 0.104). The probability of iTBCT being cost-effective in keeping patients alive remained below 0.56 for the whole group, but was higher in patients with multiple trauma (0.8-0.9) and in those with traumatic brain injury (more than 0.9). Economically, from a hospital healthcare provider perspective, iTBCT should be the diagnostic strategy of first choice in patients with multiple trauma or traumatic brain injury.