Abstract
Catheter-related infection is a complication of high morbimortality. The aim was to perform a cost-effectiveness analysis of gauze and medical tape, transparent semi-permeable and chlorhexidine-impregnated dressings for short-term central venous catheter, within the Brazilian Public Healthcare System (Sistema Único de Saúde - SUS) scenario. a decision tree was elaborated in order to evaluate the cost-effectiveness of dressings in the prevention of catheter-related infection in critically ill patients. The outcome was the probability of catheter-related infections prevention. Moreover, only direct medical expenses were considered. Sensitivity analyses were performed to evaluate the model uncertainties. Chlorhexidine-impregnated dressing presented higher cost-effectiveness when the base case was analyzed (cost of US$ 655 per case prevented, 99% of effectiveness), in comparison to gauze and medical tape dressing (US$ 696, effectiveness of 96%). Dressing changes performed before the recommended period, treatment performed exclusively in inpatient units and high effectiveness of gauze and medical tape dressing were variables that interfered with the results. The probability of death has also demonstrated to have a major impact on cost-effectiveness. In the context of a Brazilian public hospital, the chlorhexidine-impregnated dressing presented higher cost-effectiveness when compared to the gauze and medical tape dressing or the transparent semi-permeable dressing.
Highlights
Catheter-related infection is a complication of high morbimortality
Primary bloodstream infection related to central venous catheter (BSI-CVC) is a complication with high morbidity and mortality [1] associated with the use of devices, such as the percutaneous central venous catheter that is widely used in patients admitted to intensive care units (ICUs)
A systematic review evaluating the effectiveness of gauze and medical tape dressing and transparent semipermeable dressing showed that there is no difference among these dressings regarding the prevention of BSICVC
Summary
Catheter-related infection is a complication of high morbimortality. The aim was to perform a cost-effectiveness analysis of gauze and medical tape, transparent semi–permeable and chlorhexidine-impregnated dressings for short-term central venous catheter, within the Brazilian Public Healthcare System (Sistema Único de Saúde – SUS) scenario. Primary bloodstream infection related to central venous catheter (BSI-CVC) is a complication with high morbidity and mortality [1] associated with the use of devices, such as the percutaneous central venous catheter that is widely used in patients admitted to intensive care units (ICUs) In these catheters, the most common route of infection is the extraluminal one, in which the microorganisms present on the patients skin or in the hands of the professional that manipulates the device, are the main agents of contamination [2]. The most common route of infection is the extraluminal one, in which the microorganisms present on the patients skin or in the hands of the professional that manipulates the device, are the main agents of contamination [2] Strategies to prevent this complication include dressings for covering the ostium of the catheter, which comprise gauze and medical tape dressing, transparent semi-permeable dressing and chlorhexidineimpregnated dressing. The chlorhexidineimpregnated dressing, a novelty strategy, demonstrates positive results in the prevention of BSI-CVC, with a decrease in colonization (6.5% versus 13.2%) [5] and infection (1.51/1000 versus 5.87/1000 catheters-day), when compared to traditional dressings [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
