PMID- 35292833
OWN - NLM
STAT- MEDLINE
DCOM- 20220627
LR  - 20220627
IS  - 1432-086X (Electronic)
IS  - 0174-1551 (Linking)
VI  - 45
IP  - 7
DP  - 2022 Jul
TI  - Tunneled Peritoneal Catheter vs Repeated Paracenteses for Recurrent Ascites: A 
      Cost-Effectiveness Analysis.
PG  - 972-982
LID - 10.1007/s00270-022-03103-4 [doi]
AB  - PURPOSE: To compare the cost-effectiveness of tunneled peritoneal catheter (TPC) 
      versus serial large-volume paracenteses (LVP) for patients with recurrent 
      ascites. MATERIALS AND METHODS: Retrospective, single-institution analysis of 100 
      consecutive patients undergoing LVP and eventual TPC placement (2015-2018) was 
      performed with extraction of procedural complications and hospital admissions. 
      LVPs were associated with 17 adverse events (AEs) while only 9 AEs occurred after 
      TPC placement. While undergoing routine LVP, the patients had 30 hospitalizations 
      monthly (177 days in total) and 10 hospitalizations monthly (51 days) after TPC 
      placement. A cost-effectiveness analysis with Markov modeling was performed 
      comparing TPC and LVP. Costs were based on Medicare reimbursement rates. 
      Statistical analyses include base case calculation, Monte Carlo simulations, and 
      deterministic sensitivity analyses. RESULTS: TPC placement was the dominant 
      strategy with a comparable health benefit of 0.08060 quality-adjusted life-years 
      (QALY) (LVP: 0.08057 QALY) at a lower cost of $4151 (LVP: $8401). Probabilistic 
      sensitivity analysis showed TPC was superior in 97.49% of simulations. 
      Deterministic sensitivity analysis demonstrated the superiority of TPC compared 
      to LVP if the TPC complication rate was < 9.47% per week and the complication 
      rate for LVP was > 1.32% per procedure. TPC was more cost-effective when its 
      procedural cost was < $5427 (base case: 1174.5), and remained as such when the 
      cost of LVP was varied as much as $10,000 (base case: $316.48). CONCLUSION: In 
      this study, TPC was more cost-effective than LVP in patients with recurrent 
      ascites due to the reduced risk of infection, emergency department visits, and 
      length of hospitalization stays.
CI  - (c) 2022. Springer Science+Business Media, LLC, part of Springer Nature and the 
      Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
FAU - Wu, Xiao
AU  - Wu X
AUID- ORCID: 0000-0002-2679-7447
AD  - Department of Radiology and Biomedical Imaging, University of California, 505 
      Parnassus Ave, San Francisco, CA, 94143, USA. xiao.wu@ucsf.edu.
FAU - Rabei, Rana
AU  - Rabei R
AD  - Department of Radiology and Biomedical Imaging, University of California, 505 
      Parnassus Ave, San Francisco, CA, 94143, USA.
FAU - Keller, Eric J
AU  - Keller EJ
AD  - Division of Interventional Radiology, Stanford University, Stanford, CA, USA.
FAU - King, Bradley
AU  - King B
AD  - Department of Radiology and Biomedical Imaging, University of California, 505 
      Parnassus Ave, San Francisco, CA, 94143, USA.
FAU - Kothary, Nishita
AU  - Kothary N
AD  - Division of Interventional Radiology, Stanford University, Stanford, CA, USA.
FAU - Kohi, Maureen
AU  - Kohi M
AD  - Department of Radiology, University of North Carolina, Chapel Hill, NC, USA.
FAU - Taylor, Andrew
AU  - Taylor A
AD  - Department of Radiology and Biomedical Imaging, University of California, 505 
      Parnassus Ave, San Francisco, CA, 94143, USA.
FAU - Heller, Michael
AU  - Heller M
AD  - Department of Radiology and Biomedical Imaging, University of California, 505 
      Parnassus Ave, San Francisco, CA, 94143, USA.
LA  - eng
PT  - Journal Article
DEP - 20220315
PL  - United States
TA  - Cardiovasc Intervent Radiol
JT  - Cardiovascular and interventional radiology
JID - 8003538
SB  - IM
MH  - Aged
MH  - *Ascites/complications/therapy
MH  - Catheters, Indwelling/adverse effects
MH  - Cost-Benefit Analysis
MH  - Humans
MH  - Medicare
MH  - *Paracentesis/adverse effects
MH  - Retrospective Studies
MH  - United States
OTO - NOTNLM
OT  - Cost-effectiveness analysis
OT  - Palliative care
OT  - Recurrent ascites
OT  - Tunneled peritoneal catheter
EDAT- 2022/03/17 06:00
MHDA- 2022/06/28 06:00
CRDT- 2022/03/16 05:57
PHST- 2021/10/22 00:00 [received]
PHST- 2022/02/17 00:00 [accepted]
PHST- 2022/03/17 06:00 [pubmed]
PHST- 2022/06/28 06:00 [medline]
PHST- 2022/03/16 05:57 [entrez]
AID - 10.1007/s00270-022-03103-4 [pii]
AID - 10.1007/s00270-022-03103-4 [doi]
PST - ppublish
SO  - Cardiovasc Intervent Radiol. 2022 Jul;45(7):972-982. doi: 
      10.1007/s00270-022-03103-4. Epub 2022 Mar 15.