title: Cost-utility analysis of the insufflation of warmed humidified carbon dioxide during open and laparoscopic colorectal surgery.
abstract: BACKGROUND
  An evaluation was conducted to estimate the cost-effectiveness of insufflation of warmed humidified CO2during open and laparoscopic colorectal surgery compared with usual care from a UK NHS perspective.
  
  
  METHODS
  Decision analytic models were developed for open and laparoscopic surgery. Incremental costs per quality-adjusted life year (QALY) were estimated. The open surgery model used data on the incidence of intra-operative hypothermia and applied risks of complications for hypothermia and normothermia. The laparoscopic surgery model utilised data describing complications directly. Sensitivity analyses were conducted.
  
  
  RESULTS
  Compared with usual care, insufflation of warmed humidified CO2dominated. For open surgery, savings of £20 and incremental QALYs of 0.013 were estimated per patient. For laparoscopic surgery, savings of £345 and incremental QALYs of 0.001 per patient were estimated. Results were robust to most sensitivity analyses.
  
  
  CONCLUSIONS
  Considering the current evidence base, the intervention is likely to be cost-effective compared with usual care in patients undergoing colorectal surgery.
authors.affiliation: a York Health Economics Consortium, Enterprise House, Innovation Way , University of York , York , UK.
authors.forename: Michelle
authors.initials: M
authors.lastname: Jenks
authors.affiliation: a York Health Economics Consortium, Enterprise House, Innovation Way , University of York , York , UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Taylor
authors.affiliation: a York Health Economics Consortium, Enterprise House, Innovation Way , University of York , York , UK.
authors.forename: Judith
authors.initials: J
authors.lastname: Shore
mesh_terms: D002245:Carbon Dioxide / Q000008:administration & dosage*; D003107:Colorectal Surgery / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D006358:Hot Temperature; D006801:Humans; D006813:Humidity; D007035:Hypothermia / Q000517:prevention & control; D007327:Insufflation / Q000191:economics / Q000379:methods*; D007431:Intraoperative Complications / Q000517:prevention & control; D010535:Laparoscopy / Q000191:economics / Q000379:methods*; D019057:Quality-Adjusted Life Years
chemical_list: D002245:Carbon Dioxide
keywords: Cost utility analysis; colorectal surgery; economic evaluation; hypothermia