PSU8 Budget Impact Analysis of Anti-Bacterial Suture Use in Appendectomy Procedures in Spain

Abstract

Surgical Site Infection (SSIs) is the most frequent type of hospital-acquired infection, accounting for more than (37%). The prevalence of hospital-acquired infection in Spain is 7.8%, where SSI account for 19%. For appendectomy procedures, the SSI rate of 4.9% is reported. SSI increases the patient's risk of morbidity and mortality, prolongs hospital stay by more than a week, and worsens the overall patient quality of life. Moreover, the risk of SSI has increased recently due to multiple comorbidities. In addition, SSI is becoming more treatment-resistant than ever. The aim of this study was to analyze the economic consequences of using antibacterial sutures in appendectomy procedures in Spain. A dynamic excel-based decision-analytic model was developed. Published literature reviews were used to estimate the three key variables: SSI reduction using antibacterial sutures (55%7) compared to standard sutured, prolonged length of hospital stay due to SSI (7.7 days), and the cost of hospital stay per day (2,057€). The rate of readmission due to persistent infection was used (18%), which was estimated as costs 2,166€, and it was added to the prior amount to calculate total costs of infection. Country input data for the model were reported as the number of appendectomy procedures performed per year (34,500). The list price at which regular and antibacterial sutures were purchased was also collected. A two-way sensitivity analysis was conducted, with two variables being the infection rate and suture price. Antibacterial sutures were found to be 14% more expensive; however, allowing a 56% of hospital cost avoidance. This may have an impact of 4,970,273€ in annual savings in Spain. This analysis presents new evidence of support of the use of antibacterial sutures by demonstrating that it could reduce the SSI rate, and could allow cost-savings compared to standard sutures, among other benefits.