Cost-effectiveness analysis of early veno-venous hemofiltration for severe acute pancreatitis in China.
OBJECTIVE
To determine the most cost-effective hemofiltration modality for early management of severe acute pancreatitis (SAP) in China.


METHODS
We carried out a search of Pub-Medline and Chinese Biomedical Disk database. Controlled clinical trials on Chinese population were included in the analysis. The four decision branches that were analyzed were: continuous or long-term veno-venous hemofiltration (CVVH/LVVH), short-term veno-venous hemofiltration (SVVH), SVVH plus peritoneal dialysis (PD), and non-hemofiltration control group. The effectiveness of the technique was determined by survival rate, complications prevention and surgery preservation. The total cost of hospitalization was also assessed.


RESULTS
The SVVH only technique was the least costly modality, $5809 (44449 RMB), and was selected as the baseline treatment modality. SVVH only arm achieved the lowest C/E ratio in terms of overall survival, complications prevention and surgery preservation. In incremental cost-effectiveness analysis, the CVVH/LVVH only and the control arms were inferior to other techniques. Sensitivity analysis showed SVVH only and SVVH plus PD arms overlapped in C/survival ratio.


CONCLUSIONS
The role of early veno-venous hemofiltration as an alternative therapy for SAP remains controversial. However, we propose that early use of short-term high-volume veno-venous hemofiltration would have a beneficial impact on the management of SAP.
Jiang
Kun
K
Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Guo Xue Xiang No. 37, Chengdu 610041, Sichuan Province, China.
Chen
Xin-Zu
XZ
Xia
Qing
Q
Tang
Wen-Fu
WF
Wang
Lei
L
D002681:China; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D006440:Hemofiltration / Q000191:economics*; D006801:Humans; D010195:Pancreatitis / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome