Cost-effectiveness of intravenous resuscitation fluids in sepsis patients: a patient-level data analysis in Jordan

Figures & data

Figure 1. Partitioned survival model and Markovian decision tree with two health states.

Table 1. Characteristics of the study patients and admissions for the total sample and by IV fluid administered.

Variable	Total Sample N = 250	Albumin n = 127	Crystalloid n = 123	p value
Gender				.707
Male	123 (49.20)	61 (48.03)	62 (50.41)
Female	127 (50.80)	66 (51.97)	61 (49.59)
Age (years)^a	72.38 ± 15.03	70.21 ± 14.83	74.63 ± 14.97	.019
Age
≥ 65 years	195 (78.00)	93 (73.23)	102 (82.93)	.064
< 65 years	55 (22.00)	34 (26.77)	21 (17.07)
Body mass index (BMI; kg/m^2)
BMI 18.5-24.9	81 (41.54)	43 (43.88)	38 (39.18)	.623
BMI 25-29.9	64 (32.82)	29 (29.59)	35 (36.08)
BMI ≥ 30	50 (25.64)	26 (26.53)	24 (24.74)
Albumin level (g/L)^a	27.37 ± 7.26	26.01 ± 7.55	28.86 ± 6.66	.003
Albumin level				.001
Normal albumin level	56 (22.40)	17 (13.39)	39 (31.71)
Mild hypoalbuminemia	116 (46.40)	60 (47.24)	56 (45.53)
Marked hypoalbuminemia	78 (31.20)	50 (39.37)	28 (22.76)
ICU scoring systems^a
GCS	12.70 ± 4.34	12.77 ± 4.12	12.64 ± 4.54	.838
SOFA	4.90 ± 3.44	4.57 ± 2.89	5.19 ± 3.84	.248
APACHEII	12.46 ± 6.74	12.03 ± 6.83	12.84 ± 6.68	.445
Charlson Comorbidity Index^a	5.14 ± 2.46	4.84 ± 2.64	5.44 ± 2.24	.052
ICU Type				.799
Medical ICU	177 (70.80)	89 (70.08)	88 (71.54)
Surgical ICU	73 (29.20)	38 (29.92)	35 (28.46)

Abbreviations. GCS, Glasgow coma scale; SOFA, Sequential Organ Failure Assessment; APACHE, Acute Physiologic and Chronic Health Evaluation.

Data are presented as N (%) unless otherwise indicated. Categorical variables were compared using chi-square test.

^a Data are presented as mean ± standard deviation and compared using independent samples t test with normality and homogeneity of variance assumed for age, albumin level, and Charlson comorbidity index.

Figure 2. Overall survival curves for sepsis patients treated with Albumin and Crystalloids over 90-day horizon.

Table 2. The results of the cost-effectiveness analysis.

Strategy	Cost	Incremental Cost	Effectiveness	Incremental Effectiveness	ICER (per incremental 1% in the probability of being discharged alive)
Partitioned survival model
Crystalloids	$5,463		0.1266
Albumin	$8,055	$2,592	0.1524	0.0258	$1,007
Sate-transition patient-level simulation model
Crystalloids	$559		0.3270
Albumin	$653	$94	0.3277	0.0007	$1,268

Abbreviation. ICER, Incremental cost effectiveness ratio.

Figure 3. Cost-effectiveness acceptability curves of Albumin versus Crystalloids.

Data availability statement

The data underlying this article will be shared upon reasonable request to the corresponding author.