Cost-effectiveness analysis of acute kidney injury biomarkers in pediatric cardiac surgery

2015
Authors
Petrović, StanislavaBogavac-Stanojević, Nataša

Lakić, Dragana

Peco-Antić, Amira
Vulicević, Irena
Ivanišević, Ivana
Kotur-Stevuljević, Jelena

Jelić-Ivanović, Zorana

Article (Published version)

Metadata
Show full item recordAbstract
Introduction: Acute kidney injury (AKI) is significant problem in children with congenital heart disease (CHD) who undergo cardiac surgery. The economic impact of a biomarker-based diagnostic strategy for AKI in pediatric populations undergoing CHD surgery is unknown. The aim of this study was to perform the cost effectiveness analysis of using serum cystatin C (sCysC), urine neutrophil gelatinase-associated lipocalin (uNGAL) and urine liver fatty acid-binding protein (uL-FABP) for the diagnosis of AKI in children after cardiac surgery compared with current diagnostic method (monitoring of serum creatinine (sCr) level). Materials and methods: We developed a decision analytical model to estimate incremental cost-effectiveness of different biomarker-based diagnostic strategies compared to current diagnostic strategy. The Markov model was created to compare the lifetime cost associated with using of sCysC, uNGAL, uL-FABP with monitoring of sCr level for the diagnosis of AKI. The utility m...easurement included in the analysis was quality-adjusted life years (QALY). The results of the analysis are presented as the incremental cost-effectiveness ratio (ICER). Results: Analysed biomarker-based diagnostic strategies for AKI were cost-effective compared to current diagnostic method. However, uNGAL and sCys C strategies yielded higher costs and lower effectiveness compared to uL-FABP strategy. uL-FABP added 1.43 QALY compared to current diagnostic method at an additional cost of $8521.87 per patient. Therefore, ICER for uL-FABP compared to sCr was $5959.35/QALY. Conclusions: Our results suggest that the use of uL-FABP would represent cost effective strategy for early diagnosis of AKI in children after cardiac surgery.
Keywords:
acute kidney injury / cardiac surgery / children / biomarkers / cost effectiveness analysisSource:
Biochemia Medica, 2015, 25, 2, 262-271Publisher:
- Croatian Soc Medical Biochemists, Zagreb
Projects:
DOI: 10.11613/BM.2015.027
ISSN: 1330-0962
PubMed: 26110039