[Use of fish oil lipid emulsion in patients undergoing major surgery and those with systemic inflammatory response syndrome: a cost-effectiveness analysis].
OBJECTIVE
To investigate the cost-effectiveness of fish oil in patients undergoing major surgery and those with systemic inflammatory response syndrome(SIRS).


METHODS
A retrospective study was conducted in patients undergoing major surgery and those with SIRS on admission in the Zhongshan Hospital from January 2008 to December 2011. Fish oil group was enrolled and matched to control group by 1:2 for gender, age, diagnosis, and surgical procedure. There were 220 pairs of patients who were not admitted to ICU, 102 pairs of patients admitted to ICU, and 66 pairs of patients with SIRS. The clinical outcomes and costs were measured and cost-effectiveness analyses were conducted.


RESULTS
The clinical outcomes and costs showed no significant difference between the fish oil group and the control group in those patients who were not admitted to ICU(P>0.05). Fish oil fat emulsion supplementation significantly reduced the length of total hospital stay, postoperative hospital stay, ICU stay, re-operation rate, infection rates, perioperative mortality in patients admitted to ICU and those with SIRS(P<0.05). The cost-effectiveness ratio of non-reoperation rate, non-infection rate, and survival rate were lower in those patients receiving fish oil fat emulsion as compared with those without fish oil administration. Fish oil fat emulsion supplementation could reduce cost-effectiveness ratios of non-reoperation rate, non-infection rate and survival rate by 105 RMB, 160 RMB, and 89 RMB respectively in major surgical patients who admitted to ICU, and by 670 RMB, 280 RMB, and 220 RMB respectively in SIRS patients.


CONCLUSIONS
Addition of fish oil fat emulsion to clinical nutrition may have positive effects on critically ill patients. It seems that the effects of fish oil fat are strongly related to the severity of patient's underlying disease. Fish oil fat emulsion supplementation shows acceptable cost-effectiveness ratio and pharmacoeconomic value.
Department of General Surgery, Fudan University, Shanghai, China.
Jian
J
Gao
Chun-yan
CY
Ji
Guo-hao
GH
Wu
D000368:Aged; D003362:Cost-Benefit Analysis; D005217:Fat Emulsions, Intravenous / Q000191:economics* / Q000627:therapeutic use; D005260:Female; D005395:Fish Oils / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000191:economics* / Q000379:methods; D011182:Postoperative Care; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative; D018746:Systemic Inflammatory Response Syndrome / Q000628:therapy*
D005217:Fat Emulsions, Intravenous; D005395:Fish Oils