Cost-effectiveness of blood culture and a multiplex real-time PCR in hematological patients with suspected sepsis: An observational propensity score-matched study

Nicasio Mancini, Vittorio Sambri, Consuelo Corti, Nadia Ghidoli, Giulia Tolomelli, Michela Paolucci, Daniela Clerici, Silvia Carletti, Raffaella Greco, Michela Tassara, Beatrice Pizzorno, Orietta Zaniolo, Massimiliano Povero, Lorenzo Pradelli, Roberto Burioni, Marta Stanzani, Maria Paola Landini, Fabio Ciceri, Massimo Clementi

Research output: Contribution to journalArticlepeer-review

Abstract

We evaluated the costs and clinical outcomes of episodes of suspected sepsis in hematological patients. A propensity score-matched study was planned, comparing a retrospective cohort managed with standard assays and a prospective cohort managed with the addition of a molecular assay. Diagnostic procedures and therapy were considered as costs variables. The primary clinical endpoint was sepsis-related mortality, whereas the length of each suspected sepsis episode was investigated as a secondary endpoint. A total of 137 and 138 episodes in the prospective and the retrospective cohorts were studied, respectively; 101 pairs of highly matched episodes were analyzed, evidencing a trend of higher mortality in the retrospective cohort. No difference in length of suspected sepsis episode was observed. Significant savings were observed in the prospective cohort, especially due to reduced costs in antifungal therapy. The apparently more expensive molecular assay favored a more rational use of economic resources without influencing, and probably improving, the clinical outcome.

Original languageEnglish
Pages (from-to)623-632
Number of pages10
JournalExpert Review of Molecular Diagnostics
Volume14
Issue number5
DOIs
Publication statusPublished - 2014

Keywords

  • Sepsis

ASJC Scopus subject areas

  • Molecular Medicine
  • Molecular Biology
  • Genetics
  • Pathology and Forensic Medicine

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