Cost-Effectiveness of Team-Based Coaching With Surveillance for Prevention of Acute Kidney Injuries

作者：David Xiao, Sharon E. Davis, Caroline M. Godfrey, Hanxuan Yu, Elizabeth Sullivan, Jinyi Zhu, Ashley A. Leech, Kevin C. Cox, Iben M. Ricket, Michael E. Matheny, Jeremiah R. Brown, Stephen A. Deppen · 发表于：JAMA Network Open · 年份：2025 · DOI：10.1001/jamanetworkopen.2025.2503 · 被引用次数：4 · 研究领域：Acute Kidney Injury Research、Dialysis and Renal Disease Management、Chronic Kidney Disease and Diabetes

Importance: More than 10% of US patients undergoing endovascular procedures experience contrast-associated acute kidney injuries (AKIs), resulting in increased costs and health deficits. Prevention protocols reduce AKIs, but uptake and adherence vary greatly, and the cost-effectiveness of these interventions is unknown. Objective: To analyze the cost-effectiveness of 4 implementation interventions for AKI prevention in patients undergoing cardiac catheterizations. Design, Setting, and Participants: This economic evaluation used a Markov decision model with 3-year horizon was constructed to simulate quality-adjusted life years (QALYs) and costs after AKI prevention protocol implementation for patients undergoing cardiac catheterization. Data from the IMPROVE AKI trial, a cluster-randomized trial conducted across 20 US Department of Veterans Affairs medical centers from 2019 to 2021, were used for probabilities, with economic and utility data derived from literature. Patients aged 18 years or older, who underwent cardiac coronary angiography for diagnostic or treatment of pathology were included. Patients with a history of dialysis (hemodialysis or peritoneal dialysis) were excluded. Data were analyzed from January to June 2024. Exposure: Interventions compared were assistance, assistance with surveillance, collaborative, and collaborative with surveillance. Main Outcomes and Measures: QALYs and cost in dollars discounted at 3% per year and incremental cost-effectiveness ratio ...