Cost-Effectiveness of Routine X-Rays After Central Venous Catheter Removal: A Value-Based Analysis of Post-Removal Complications

Journal of Clinical Medicine, Год журнала: 2025, Номер 14(4), С. 1397 - 1397

Опубликована: Фев. 19, 2025

Background: Healthcare systems worldwide are increasingly burdened by rising costs, growing patient demand, and limited resources. In this context, cost-effectiveness analysis (CEA) plays a vital role in evaluating the clinical value of medical interventions relative to their costs. Despite lack evidence supporting necessity, routine post-removal chest X-rays for central venous catheters (CVCs) still performed some hospitals due persistent misconceptions about benefits. This study seeks address these examining costs imaging through cost complication detection rates large inpatient cohort, with aim highlighting inefficiencies practice promoting evidence-based approaches. Methods: A retrospective cohort was across four university Salzburg, Austria, including 984 CVC removals conducted between 2012 2021. Comparisons were made after primary catheter insertion isolate complications specifically associated removal. simple cost-per-outcome analysis, subtype CEA, chosen determine per detected. The approach incorporated activity-based costing, adjusted 2024 price levels via Austrian Consumer Price Index (CPI), capture real-world resource utilization. Results: Complications related removal identified five cases (0.5%), one rupture self-removal, two failed removals, hemothorax, case intrathoracic bleeding. Of these, three detected on X-rays, retained fragment, signs bleeding, hemothorax. Additionally, asymptomatic had likely incidental finding small pneumothorax, which required no intervention. calculated at EUR 38.20 X-ray, resulting total expenditure 37,588.80 X-rays. corresponds 7517.76 (n = 4). odds detecting an X-ray 193 times higher symptomatic patients than (p < 0.001). Conclusions: confirms that following rare only cases. Routine did not improve decision-making, as significantly more be evaluation alone. Given high financial (EUR complication), unnecessary should reserved based judgment. Adopting symptom-based would reduce healthcare minimize radiation exposure, optimize allocation high-volume procedures such

Язык: Английский

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Physicochemical Characteristics of Cardiological Drugs and Practical Recommendations for Intravenous Administration: A Systematic Review

Scientia Pharmaceutica, Год журнала: 2025, Номер 93(1), С. 13 - 13

Опубликована: Март 12, 2025

Most cardiological drugs need intravenous administration to have a fast effect in an emergency. Intravenous is linked complications, such as tissue infiltration and thrombophlebitis. Aiming supply effective tool for the development of appropriate policies, this systematic review provides practical recommendations about diluent, pH, osmolarity, dosage, vesicant properties, phlebitis rate most commonly used evaluated randomized controlled trials (RCTs) till 31 August 2024. The authors searched available IV RCTs PUBMED EMBASE®, EBSCO-CINAHL®, Cochrane Controlled Clinical trials. Drugs’ chemical features were obtained online, drug data sheets, scientific papers, establishing that with pH <5 or >9, osmolarity > 600 mOsm/L, high incidence reported literature, well drugs, require utmost caution during administration. A total 857 papers 316 studies included. 84 identified, which only (37%) can be safely infused via peripheral route. Thrombolytics anticoagulants are considered safest classes one flagged “red flag” medication. However, higher percentage other categories meet criteria, including antiarrhythmics (52%), antiplatelet agents (67%), diuretics antihypertensives (70%), (77%), vasoconstrictors inotropics (89%). Understanding physicochemical properties essential significantly improving patient safety preventing errors local side effects.

Язык: Английский

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The importance of echo guided tip navigation before “bubble test” tip location during PICC placement

The Journal of Vascular Access, Год журнала: 2025, Номер unknown

Опубликована: Март 23, 2025

Язык: Английский

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Impact of a ‘Catheter Bundle’ on Infection Rates and Economic Costs in the Intensive Care Unit: A Retrospective Cohort Study

Nursing Reports, Год журнала: 2024, Номер 14(3), С. 1948 - 1960

Опубликована: Авг. 9, 2024

Catheter-related infections (CBRSIs) are a widespread problem that increase morbidity and mortality in intensive care unit (ICU) patients management costs.

Язык: Английский

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Choosing the optimal vascular access in perioperative and intensive care

Anesteziologie a intenzivní medicína, Год журнала: 2024, Номер 35(3), С. 185 - 187

Опубликована: Окт. 7, 2024

Язык: Английский

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Správná kanylace centrálního žilního katétru

Anesteziologie a intenzivní medicína, Год журнала: 2024, Номер 35(4), С. 254 - 257

Опубликована: Дек. 17, 2024

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