Perioperative medicine & outcomes
Cost-effectiveness of a high-sensitivity cardiac troponin T systematic screening strategy compared with usual care to identify patients with peri-operative myocardial injury after major noncardiac surgery
An erratum to this article was published (Eur J Anaesthesiol, 1 Sep 2023 ↗)
Authors' conclusion
Our results suggest that systematic peri-operative PMI screening with hs-cTnT may be cost-effective in the short-term in patients undergoing major noncardiac surgery.
Study context
- Population
- Consecutive patients aged ≥65, or <65 with cardiovascular disease or impaired renal function, undergoing major noncardiac surgery with at least an overnight stay, Spanish University Hospital, 2016–2019
- Participants
- 1,477 patients
- Exposure
- Systematic high-sensitivity cardiac troponin T (hs-cTnT) screening vs usual care
- Outcome
- ICER of the systematic hs-cTnT screening strategy (expected cost per any additional PMI detected; Euros-2021)
- Follow-up
- 30 days
Methodological detailsdecision-tree analysis, single centre prospective cohort study, third-party payer perspective, deterministic and probabilistic sensitivity analysis
- Decision-tree analysis
- Single centre prospective cohort study
- Third-party payer perspective
- Deterministic and probabilistic sensitivity analysis
Main finding
As reported in the abstract
ICER of systematic hs-cTnT screening strategy vs usual care (cost per any additional PMI detected; Euros-2021, third-party payer, 30 days)
Incremental cost-effectiveness ratio (ICER) per any additionally detected PMI
€425
Observational data: associations, not effects.
Further findings
Deterministic sensitivity analysis
- 15% variation in costs and 1% variation in predictive values had minor impact on ICER, except NPV of the systematic hs-cTnT strategy
Probabilistic sensitivity analysis (Monte Carlo simulations)
- Cost-effective in 100% of cases with a willingness to pay of €780
Original publication
Cost-effectiveness of a high-sensitivity cardiac troponin T systematic screening strategy compared with usual care to identify patients with peri-operative myocardial injury after major noncardiac surgery. Eur J Anaesthesiol. Published 11 January 2023. doi:10.
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