Use of a collagen hemostatic closure device to achieve hemostasis after arterial puncture: a cost-effectiveness analysis.
OBJECTIVE
To evaluate whether a collagen hemostatic closure device is a safe, cost-effective alternative to manual compression for achieving hemostasis at arterial puncture sites.


METHODS
A cost-effectiveness analysis, based on a meta-analysis of published data, was performed from the perspective of the health-care system. The gain in effectiveness was expressed as the decrease in rate of puncture-site complications that required treatment. Costs associated with achieving hemostasis and treating complications were included.


RESULTS
Use of a collagen closure device decreased the number of puncture-site complications from 31:1,000 to 16:1,000. The average cost of using the device was $177 per patient compared with $42 per patient for manual compression. The incremental cost of averting one complication exceeded $9,000.


CONCLUSIONS
Use of a collagen closure device to achieve hemostasis after an arterial puncture may reduce the complication rate, but the additional cost per complication averted is very high.
Bos
J J
JJ
Department of Health Sciences, University Hospital Groningen, The Netherlands.
Hunink
M G
MG
Mali
W P
WP
D017541:Aneurysm, False / Q000191:economics / Q000209:etiology / Q000628:therapy; D000792:Angiography / Q000009:adverse effects; D001158:Arteries; D001164:Arteriovenous Fistula / Q000191:economics / Q000209:etiology / Q000628:therapy; D001803:Blood Transfusion / Q000191:economics; D003094:Collagen / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003663:Decision Trees; D005069:Evaluation Studies as Topic; D006406:Hematoma / Q000191:economics / Q000209:etiology / Q000628:therapy; D006489:Hemostatic Techniques / Q000191:economics / Q000295:instrumentation*; D006490:Hemostatics / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D011312:Pressure; D011677:Punctures / Q000009:adverse effects; D015641:Radiography, Interventional; D012449:Safety; D012680:Sensitivity and Specificity
D006490:Hemostatics; D003094:Collagen