PMID- 29535525
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220316
IS  - 1176-6336 (Print)
IS  - 1178-203X (Electronic)
IS  - 1176-6336 (Linking)
VI  - 14
DP  - 2018
TI  - Clinical and economic burden of procedural sedation-related adverse events and 
      their outcomes: analysis from five countries.
PG  - 393-401
LID - 10.2147/TCRM.S154720 [doi]
AB  - BACKGROUND: Studies have reported on the incidence of sedation-related adverse 
      events (AEs), but little is known about their impact on health care costs and 
      resource use. METHODS: Health care providers and payers in five countries were 
      recruited for an online survey by independent administrators to ensure that 
      investigators and respondents were blinded to each other. Surveys were conducted 
      in the local language and began with a "screener" to ensure that respondents had 
      relevant expertise and experience. Responses were analyzed using Excel and R, 
      with the Dixon's Q statistic used to identify and remove outliers. Global and 
      country-specific average treatment patterns were calculated via bootstrapping; 
      costs were mean values. The sum product of costs and intervention probability 
      gave a cost per AE. RESULTS: Responses were received from 101 providers and 26 
      payers, the majority having >5 years of experience. At a minimum, the respondents 
      performed a total of 3,430 procedural sedations per month. All AEs detailed 
      occurred in clinical practice in the last year and were reported to cause 
      procedural delays and cancellations in some patients. Standard procedural 
      sedation costs ranged from euro74 (Germany) to $2,300 (US). Respondents estimated 
      that AEs would increase costs by between 16% (Italy) and 179% (US). Hypotension 
      was reported as the most commonly observed AE with an associated global mean cost 
      (interquartile range) of $43 ($27-$68). Other frequent AEs, including mild 
      hypotension, bradycardia, tachycardia, mild oxygen desaturation, hypertension, 
      and brief apnea, were estimated to increase health care spending on procedural 
      sedation by $2.2 billion annually in the US. CONCLUSION: All sedation-related AEs 
      can increase health care costs and result in substantial delays or cancellations 
      of subsequent procedures. The prevention of even minor AEs during procedural 
      sedation may be crucial to ensuring its value as a health care service.
FAU - Saunders, Rhodri
AU  - Saunders R
AD  - Coreva Scientific GmbH & Co KG, Freiburg, Germany.
FAU - Davis, Jason A
AU  - Davis JA
AD  - Coreva Scientific GmbH & Co KG, Freiburg, Germany.
FAU - Kranke, Peter
AU  - Kranke P
AD  - Department of Anaesthesia and Critical Care, University of Wurzburg, Wurzburg, 
      Germany.
FAU - Weissbrod, Rachel
AU  - Weissbrod R
AD  - Medical Affairs, Medtronic, Jerusalem, Israel.
FAU - Whitaker, David K
AU  - Whitaker DK
AD  - Department of Anaesthesia, Manchester Royal Infirmary, Manchester, UK.
FAU - Lightdale, Jenifer R
AU  - Lightdale JR
AD  - Pediatric Gastroenterology, Hepatology and Nutrition, University of 
      Massachusetts, Worcester, MA, USA.
LA  - eng
PT  - Journal Article
DEP - 20180228
PL  - New Zealand
TA  - Ther Clin Risk Manag
JT  - Therapeutics and clinical risk management
JID - 101253281
PMC - PMC5836671
OTO - NOTNLM
OT  - complications
OT  - costs
OT  - health care payers
OT  - moderate sedation
OT  - questionnaire
OT  - survey
COIS- Disclosure RS is the owner and JAD an employee of Coreva Scientific GmbH & Co. 
      KG, which received consultancy fees for performing, analyzing, and communicating 
      the work presented here. RW is an employee of Medtronic Inc., which funded the 
      research. JRL and DKW did not receive remuneration from Medtronic Inc. PK 
      received an honorarium from Medtronic Inc. JRL is a contracted medical consultant 
      for Coreva Scientific GmbH & Co. KG. The authors report no other conflicts of 
      interest in this work.
EDAT- 2018/03/15 06:00
MHDA- 2018/03/15 06:01
PMCR- 2018/02/28
CRDT- 2018/03/15 06:00
PHST- 2018/03/15 06:00 [entrez]
PHST- 2018/03/15 06:00 [pubmed]
PHST- 2018/03/15 06:01 [medline]
PHST- 2018/02/28 00:00 [pmc-release]
AID - tcrm-14-393 [pii]
AID - 10.2147/TCRM.S154720 [doi]
PST - epublish
SO  - Ther Clin Risk Manag. 2018 Feb 28;14:393-401. doi: 10.2147/TCRM.S154720. 
      eCollection 2018.