The pharmacoeconomics of routine postoperative troponin surveillance to prevent and treat myocardial infarction after non-cardiac surgery

dc.contributor.authorTorborg, Alex
dc.contributor.authorRyan, Lisa
dc.contributor.authorKantor, Gary
dc.contributor.authorBiccard, Bruce M
dc.date.accessioned2021-10-08T07:20:30Z
dc.date.available2021-10-08T07:20:30Z
dc.date.issued2014
dc.description.abstractBACKGROUND: A postoperative troponin leak that was previously considered clinically insignificant has been independently associated with 30-day mortality in unselected surgical patients 45 years of age following non-cardiac surgery. OBJECTIVES: To determine whether routine troponin surveillance following non-cardiac surgery and initiation of aspirin and statin therapy in troponin-positive patients is cost-effective. METHODS: Pharmacoeconomic analysis to determine the cost-effectiveness of routine postoperative surveillance for patients aged 45 years undergoing non-cardiac surgery. We compared the total expected cost of hospital care of patients who received routine troponin surveillance and subsequent introduction of statin and aspirin therapy for 30 days in troponin-positive patients with the cost of hospital care of patients who did not receive troponin surveillance. We estimated a 25% relative risk reduction following statin and aspirin therapy for postoperative vascular mortality and non-fatal myocardial infarction. RESULTS: Routine troponin surveillance with initiation of aspirin and statin therapy was cost-effective, with an incremental cost of -R16 724 per event avoided. CONCLUSION: Routine postoperative troponin surveillance in non-cardiac surgical patients 45 years of age requiring a postoperative night in hospital is potentially cost-effective.
dc.identifier.apacitationTorborg, A., Ryan, L., Kantor, G., & Biccard, B. M. (2014). The pharmacoeconomics of routine postoperative troponin surveillance to prevent and treat myocardial infarction after non-cardiac surgery. <i>South African Medical Journal</i>, 104(9), 619 - 177. http://hdl.handle.net/11427/34937en_ZA
dc.identifier.chicagocitationTorborg, Alex, Lisa Ryan, Gary Kantor, and Bruce M Biccard "The pharmacoeconomics of routine postoperative troponin surveillance to prevent and treat myocardial infarction after non-cardiac surgery." <i>South African Medical Journal</i> 104, 9. (2014): 619 - 177. http://hdl.handle.net/11427/34937en_ZA
dc.identifier.citationTorborg, A., Ryan, L., Kantor, G. & Biccard, B.M. 2014. The pharmacoeconomics of routine postoperative troponin surveillance to prevent and treat myocardial infarction after non-cardiac surgery. <i>South African Medical Journal.</i> 104(9):619 - 177. http://hdl.handle.net/11427/34937en_ZA
dc.identifier.issn0038-2469
dc.identifier.ris TY - Journal Article AU - Torborg, Alex AU - Ryan, Lisa AU - Kantor, Gary AU - Biccard, Bruce M AB - BACKGROUND: A postoperative troponin leak that was previously considered clinically insignificant has been independently associated with 30-day mortality in unselected surgical patients 45 years of age following non-cardiac surgery. OBJECTIVES: To determine whether routine troponin surveillance following non-cardiac surgery and initiation of aspirin and statin therapy in troponin-positive patients is cost-effective. METHODS: Pharmacoeconomic analysis to determine the cost-effectiveness of routine postoperative surveillance for patients aged 45 years undergoing non-cardiac surgery. We compared the total expected cost of hospital care of patients who received routine troponin surveillance and subsequent introduction of statin and aspirin therapy for 30 days in troponin-positive patients with the cost of hospital care of patients who did not receive troponin surveillance. We estimated a 25% relative risk reduction following statin and aspirin therapy for postoperative vascular mortality and non-fatal myocardial infarction. RESULTS: Routine troponin surveillance with initiation of aspirin and statin therapy was cost-effective, with an incremental cost of -R16 724 per event avoided. CONCLUSION: Routine postoperative troponin surveillance in non-cardiac surgical patients 45 years of age requiring a postoperative night in hospital is potentially cost-effective. DA - 2014 DB - OpenUCT DP - University of Cape Town IS - 9 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 2014 SM - 0038-2469 T1 - The pharmacoeconomics of routine postoperative troponin surveillance to prevent and treat myocardial infarction after non-cardiac surgery TI - The pharmacoeconomics of routine postoperative troponin surveillance to prevent and treat myocardial infarction after non-cardiac surgery UR - http://hdl.handle.net/11427/34937 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34937
dc.identifier.vancouvercitationTorborg A, Ryan L, Kantor G, Biccard BM. The pharmacoeconomics of routine postoperative troponin surveillance to prevent and treat myocardial infarction after non-cardiac surgery. South African Medical Journal. 2014;104(9):619 - 177. http://hdl.handle.net/11427/34937.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Anaesthesia and Perioperative Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Medical Journal
dc.source.journalissue9
dc.source.journalvolume104
dc.source.pagination619 - 177
dc.source.urihttps://dx.doi.org/10.7196/SAMJ.7654
dc.subject.otherAspirin
dc.subject.otherCost-Benefit Analysis
dc.subject.otherEconomics, Pharmaceutical
dc.subject.otherHospital Costs
dc.subject.otherHumans
dc.subject.otherHydroxymethylglutaryl-CoA Reductase Inhibitors
dc.subject.otherMiddle Aged
dc.subject.otherMyocardial Infarction
dc.subject.otherPostoperative Complications
dc.subject.otherRisk
dc.subject.otherTroponin
dc.subject.otherHydroxymethylglutaryl-CoA Reductase Inhibitors
dc.subject.otherTroponin
dc.titleThe pharmacoeconomics of routine postoperative troponin surveillance to prevent and treat myocardial infarction after non-cardiac surgery
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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