Abstract
Purpose: Historically, studies suggested that intraoperative hypothermia (IH) could result in significant resource consumption, but more recent studies have found the opposite. The purpose of this study is to estimate the value of active warming devices for IH prevention based on synthesized evidence. Methods: A cost-benefit analysis was conducted using the effect of active warming versus passive warming devices for intraoperative hypothermia from a meta-analysis. The item-based aggregated treatment cost approach was adopted to estimate the cost of each adverse event, which was then weighted to calculate the total cost of IH. Results: IH was associated with higher risks of bleeding, surgical site infection, and shivering compared with normothermia. The cost of one case of IH was $363.80, and the use of active warming devices might save $152.80. Extra investment in active warming (e.g., $291.00) might only be cost-beneficial when the minimum willingness-to-pay is $150.00. Conclusions: Synthesized evidence showed that the cost of IH might be overestimated. Furthermore, the value of using active warming devices remains uncertain because the willingness to pay may vary between decision-makers. As not enough awareness of hypothermia prevention in some countries, further research into the clinical use of active warming devices during major surgeries is warranted.
Highlights
IntroductionNormal body temperature is maintained at approximately 37 ◦ C by neurohumoral
Body temperature is an important vital sign of human beings
Though the above we could estimate: (1) The total cost of intraoperative hypothermia (IH): based on the incidence of each adverse event multiplied by the cost of such events; (2) The net benefit of active warming devices for IH prevention: using a decision-tree model that compared the differences in IH incidence for active warming versus passive warming devices; (3) The value of active warming devices for IH prevention: discussed by assuming different levels of investment in IH prevention under various levels of WTP
Summary
Normal body temperature is maintained at approximately 37 ◦ C by neurohumoral. It is essential for maintaining body function, physiological stability, and normal metabolism. IH has been associated with adverse events such as surgical site infection [2], increased intraoperative blood loss [3], pain, and shivering [4]. This may increase the duration of surgery [5], intensive care unit stays [6], hospital stay [7], and reportedly increase the cost of treatment [8]. Perioperative body temperature management has been recognized as an important component in the clinical pathway of enhanced recovery after surgery [9]
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