Abstract：
PURPOSE:To determine the cost-effectiveness of implementing a point-of-care (POC) Lactate Program in the emergency department (ED) for patients with suspected sepsis to identify patients who can benefit from early resuscitation. MATERIALS AND METHODS:We constructed a cost-effectiveness model to examine an ED with 30 000 patients annually. We evaluated a POC lactate program screening patients with suspected sepsis for an elevated lactate ≥4 mmol/L. Those with elevated lactate levels are resuscitated and their lactate clearance is evaluated by serial POC lactate measurements. The POC Lactate Program was compared with a Usual Care Strategy in which all patients with sepsis and an elevated lactate are admitted to the intensive care unit. Costs were estimated from the 2014 Medicare Inpatient and National Physician Fee schedules, and hospital and industry estimates. RESULTS:In the base-case, the POC Lactate Program cost $39.53/patient whereas the Usual Care Strategy cost $33.20/patient. The screened patients in the POC arm resulted in 1.07 quality-adjusted life years for an incremental cost-effectiveness ratio of $31 590 per quality-adjusted life year gained, well below accepted willingness-to-pay-thresholds. CONCLUSIONS:Implementing a POC Lactate Program for screening ED patients with suspected sepsis is a cost-effective intervention to identify patients responsive to early resuscitation.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Ward MJ,Self WH,Singer A,Lazar D,Pines JMdoi
10.1016/j.jcrc.2016.06.031subject
Has Abstractpub_date
2016-12-01 00:00:00pages
69-75eissn
0883-9441issn
1557-8615pii
S0883-9441(16)30173-3journal_volume
36pub_type
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pub_type： 杂志文章
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更新日期：2017-08-01 00:00:00
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journal_title：Journal of critical care
pub_type： 杂志文章
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更新日期：2018-04-01 00:00:00
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更新日期：2018-12-01 00:00:00
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pub_type： 杂志文章,评审
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更新日期：2013-08-01 00:00:00
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pub_type： 杂志文章
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更新日期：2018-04-01 00:00:00
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pub_type： 杂志文章
doi：10.1016/0883-9441(94)90029-9
更新日期：1994-03-01 00:00:00
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pub_type： 杂志文章
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更新日期：2019-02-01 00:00:00
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更新日期：2017-06-01 00:00:00
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更新日期：1993-09-01 00:00:00
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pub_type： 杂志文章,实务指引
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更新日期：2015-10-01 00:00:00
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更新日期：2020-04-01 00:00:00
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更新日期：2018-04-01 00:00:00
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更新日期：2008-09-01 00:00:00
abstract：:While the risk of death after nonthermal trauma and sepsis may be higher for men, sex differences in outcome after burns are inconsistently reported. The Burns Evaluation And Mortality Study examined the outcomes of all patients admitted after thermal injury to the intensive care unit (ICU) at 8 of 9 burn referral cen...
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更新日期：2014-08-01 00:00:00
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更新日期：2013-04-01 00:00:00
