Comparison of Dexmedetomidine Versus Propofol on Hospital Costs and Length of Stay

Patanwala, Asad E.; Erstad, Brian L.

doi:10.1177/0885066614544452

Cited by 17 publications

(9 citation statements)

References 7 publications

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“…18,24,33 Previous cost studies have demonstrated that clinical outcomes associated with sedative choice can impact the overall cost of an ICU stay. 18,24,30,[33][34][35][36][37] The drivers of cost savings in this analysis were also consistent with previous studies, with the key driver of high costs being the fixed room and board costs associated with the ICU stay. 18,24,33,37 The absolute costs and the magnitude of the cost differences, however, differed between our analysis and previous cost studies which included mixed patient populations requiring both long-term and short-term sedation.…”

Section: Discussionsupporting

confidence: 88%

“…In that analysis, total hospital costs when ICU patients were treated with dexmedetomidine were $46,716 compared to $31,041 in the propofol group. 37 However, the increased LOS that drove the cost differential was not adjusted for potential unmeasured confounders, such as dosing, level of sedation, delirium screening, or rescue sedation. Additionally, there were several observed differences between the two patient populations (eg, age, sex, race, admission type, service category, and severity of illness) that may suggest selection bias for treatment with each sedative.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, there were several observed differences between the two patient populations (eg, age, sex, race, admission type, service category, and severity of illness) that may suggest selection bias for treatment with each sedative. 37 …”

Section: Discussionmentioning

confidence: 99%

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<p>Cost-Minimization Analysis of Dexmedetomidine Compared to Other Sedatives for Short-Term Sedation During Mechanical Ventilation in the United States</p>

Aggarwal¹,

Lustrino²,

Stephens³

et al. 2020

CEOR

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Purpose: Mechanical ventilation (MV) remains a substantial cost driver in intensive care units (ICU) in the United States (US). Evaluations of standard sedation treatments used to relieve pain and discomfort in this setting have found varying impacts on ICU length of stay. This cost analysis examines both length-of=stay costs and the total cost implications among MV patients receiving common sedative treatments (dexmedetomidine, propofol, or midazolam) in short-term sedation settings (<24 hours). Methods: A cost-minimization model was conducted from the hospital provider perspective. Clinical outcomes were obtained from published literature and included ICU length of stay, MV duration, prescription of sedatives and pain medication, and the occurrence of adverse events. Outcomes costs were obtained from previously conducted ICU cost studies and Medicare payment fee schedules. All costs were estimated in 2018 US Dollars.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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<p>Cost-Minimization Analysis of Dexmedetomidine Compared to Other Sedatives for Short-Term Sedation During Mechanical Ventilation in the United States</p>

Aggarwal¹,

Lustrino²,

Stephens³

et al. 2020

CEOR

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“…Results found that there was no significant difference between the 2 groups in terms of the length of hospital stay. Patanwala et al [24] found that use of dexmedetomidine was associated with increased lengths of ICU and hospital stay. However, this was a retrospective study and author also stated that future prospective trials are needed to confirm their conclusions.…”

Section: Discussionmentioning

confidence: 99%

“…When compared with propofol for sedation in the ICU, dexmedetomidine may increase the length of hospital stay. [24] Obviously, prolonged length of hospital stay may increase the economic costs for the patients. Ren et al [19] found that administration of dexmedetomidine could significantly decrease the length of hospital stay when compared with the control group.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of dexmedetomidine for treatment of patients with sepsis

Zhang

Xu²,

Zhan

et al. 2019

Medicine

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Background: This meta-analysis aimed to evaluate the effect of dexmedetomidine on prognosis in patients with sepsis. Methods: Computer-related electronic databases were searched, including PubMed, Embase, Web of Science, the Cochrane Library, and the China National Knowledge Infrastructure, from the date of database construction to January 2019. Stata 12.0 was used to perform a meta-analysis of short-term mortality [intensive care unit (ICU) mortality or 28-day mortality], ICU length of stay, and mechanical ventilation. Mortality was expressed using risk ratio (RR) and 95% confidence interval (CI). ICU length of stay and mechanical ventilation were expressed as weighted mean difference (WMD) and 95% CIs. Results: We finally included 8 randomized controlled trials in this meta-analysis. Compared with the control group, the dexmedetomidine group had a lower occurrence of 28-day mortality (RR, 0.49; 95% CI, 0.35 to 0.69; P = .000) and ICU mortality (RR, 0.44; 95% CI, 0.23 to 0.84; P = .013). However, there was no statistically significant difference for the length of hospital stay (WMD, −0.05; 95% CI, −0.59 to 0.48; P = .840) and mechanical ventilation time (WMD, 1.05; 95% CI, −0.27 to 2.37; P = .392) between dexmedetomidine group and control group. Conclusions: In patients with sepsis, dexmedetomidine can reduce the short-term mortality of patients, but could not shorten the ICU length of stay and mechanical ventilation time. More clinical randomized controlled trials are needed to verify the efficacy and safety of dexmedetomidine on the length of hospital stay and mechanical ventilation time.

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Dexmedetomidine versus morphine infusion following laparoscopic bariatric surgery: effect on supplemental narcotic requirement during the first 24 h

et al. 2015

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Comparison of Dexmedetomidine Versus Propofol on Hospital Costs and Length of Stay

Cited by 17 publications

References 7 publications

<p>Cost-Minimization Analysis of Dexmedetomidine Compared to Other Sedatives for Short-Term Sedation During Mechanical Ventilation in the United States</p>

<p>Cost-Minimization Analysis of Dexmedetomidine Compared to Other Sedatives for Short-Term Sedation During Mechanical Ventilation in the United States</p>

Efficacy of dexmedetomidine for treatment of patients with sepsis

Dexmedetomidine versus morphine infusion following laparoscopic bariatric surgery: effect on supplemental narcotic requirement during the first 24 h

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