Key result
Perioperative hemodynamic optimization shows no mortality benefit over standard therapy but cuts complications and costs.
Why the study?
Hemodynamic optimization therapy may reduce hospital stay, complications, and costs, but Brazilian data are scarce.
Does hemodynamic optimization therapy reduce complications and hospital costs in surgical patients?
Meta-Analysis (n=4,872)
Does hemodynamic optimization therapy reduce complications and hospital costs in surgical patients?
Answers are grounded in this paper and cite their sources.
Perioperative hemodynamic optimization therapy in surgical patients reduces clinical complications and is cost-effective from the perspective of the Brazilian public health system.
Background: Health resources are limited and need to be rationally distributed. Studies suggest that hemodynamic optimization therapy can reduce length of hospital stay, complications and costs. However, Brazilian data are scarce. Therefore, the objective of this analysis was to evaluate whether the improvement demonstrated by hemodynamic optimization therapy in surgical patients could result in lower costs from the perspective of the Brazilian public unified health s ystem (SUS). Method: A meta-analysis was performed comparing surgical patients who underwent hemodynamic optimization therapy (intervention) with patients submitted to standard therapy (control) in terms of complications and hospital costs. The cost-effectiveness analysis evaluated the clinical and financial benefits of hemodynamic optimization protocols for surgical patients. The analysis considered the clinical outcomes of randomized studies published in the last 20 years that involved surgeries and hemodynamic optimization therapy. Indirect costs were not included in the analysis. Results: A total of 21 clinical trials with a total of 4872 surgical patients were selected. Comparison of the intervention and control groups showed lower rates of infectious (RR=0.66; 95% CI=0.58-0.74), renal (RR=0.68; 95% CI=0.54-0.87), and cardiovascular complications (RR=0.87; 95% CI=0.76-0.99) and a tendency toward lower rates of respiratory complications (RR=0.82; 95% CI=0.67-1.02). There was no difference in mortality (RR=1.02; 95% CI=0.80-1.3) between groups. In the analysis of total costs, the intervention group showed a cost reduction of R$396,024.83 for every 1000 patients treated compared to the control group. The patients in the intervention group showed greater effectiveness, with 1.0 fewer day in the ICU and hospital. In addition, there were 333 fewer patients with complications, with a consequent reduction of R$1,630,341.47 for every 1000 patients treated. Conclusions: Hemodynamic optimization therapy is cost-effective and would increase efficiency and decrease the burden of the Brazilian public health system.
No takes yet. Share an insight, caveat, or question.
Silva et al. (2020) conducted a meta-analysis in High-risk surgical patients (n=4,872). Perioperative hemodynamic optimization therapy vs. Standard therapy was evaluated on Mortality (RR 1.02, 95% CI 0.80-1.31). Perioperative hemodynamic optimization therapy did not significantly reduce mortality (RR 1.02) but reduced complications and hospital costs by R$396,024.83 per 1000 patients treated compared to standard therapy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: