@conference{
author = "Bogavac-Stanojević, Nataša and Petrović, S. and Lakić, Dragana and Antić, Peco A. and Vulicević, Irena and Ivanišević, Ivana and Kotur-Stevuljević, Jelena and Jelić-Ivanović, Zorana",
year = "2014",
abstract = "Objectives: Children undergoing cardiac surgery for congenital heart disease are
more likely to experience development of acute kidney injury (AKI) in the immedi-
ate postoperative period. In current clinical practice, AKI diagnosis is based on a
rise in serum creatinine (sCr) levels, which occurs 2-3 days after the initiating renal
insult. Many new biomarkers offer promise for earlier AKI diagnosis. The objective was to assess the incremental cost effectiveness of using serum CysC (sCysC), urine
NGAL (uNGAL) and urine L-FABP (uL-FABP) for the diagnosis of AKI in children
after cardiac surgery compared with current diagnostic method (monitoring of sCr
level). MeThoDs: We developed a decision analytical model to estimate quality-
adjusted life years (QALY), lifetime costs and incremental cost-effectiveness of dif-
ferent biomarker-based diagnostic strategies which can be used in clinical practice
compared to current strategy.This model simulates detection of AKI, its progression
to chronic kidney disease (CKD) and CKD treatment in cohort of patients younger
than 18 years. ResulTs: The cost-effectiveness ratios were between $1485/QALY for
sCr and $3579/QALY for uNGAL. uNGAL and sCys C strategies yielded higher costs
and lower effectiveness (ie. dominated) compared to uL-FABP strategy. uL-FABP
added 1.43 QALY compared to current diagnostic method at an additional cost of
$8521.87. ICER for uL-FABP compared to sCr was $5959.35/QALY. Probabilistic sensi-
tivity analyses indicated that the uL-FABP strategy was cost-effective for all 10.000
patient simulations at specified $50000/QALY threshold. ConClusions: Our results
suggest that the use of uL-FABP is likely to represent an economically advantageous
strategy for early AKI diagnosis in children after cardiac surgery. However, we need
rapid screening uL-FABP test to ensure timely and efficient AKI treatment.",
publisher = "Elsevier Science Inc",
journal = "Value in Health",
title = "Cost-effectiveness analysis of the new biomarkers for diagnosis of acute kidney injury in children after cardiac surgery",
volume = "17",
number = "7, 7",
pages = "A510-A511",
doi = "10.1016/j.jval.2014.08.1567"
}
