Original scientific paper

https://doi.org/10.11613/BM.2015.027

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

Stanislava Petrovic ; Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
Natasa Bogavac-Stanojevic ; Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
Dragana Lakic ; Department of Social Pharmacy and Pharmacy Legislation, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
Amira Peco-Antic ; School of Medicine, University of Belgrade, Belgrade, Serbia
Irena Vulicevic ; Department of Nephrology, University Children’s Hospital, Belgrade, Serbia
Ivana Ivanisevic ; Department of Nephrology, University Children’s Hospital, Belgrade, Serbia
Jelena Kotur-Stevuljevic ; Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
Zorana Jelic-Ivanovic ; Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia

Abstract

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 measurement 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 analysis

Hrčak ID:

139813

URI

https://hrcak.srce.hr/139813

Publication date:

15.6.2015.

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