Potential mortality and cost reduction in adult severe sepsis and septic shock through the use of an innovative fluid delivery device

Figures & data

Figure 1 Decision tree model structure.

Table 1 Costs and outcome assumptions for bundle compliance vs non-compliance

	Bundle compliant (Paths 1 and 3)	Bundle non-compliant (Paths 2 and 4)
Standard method compliance rate	26%	74%
New method compliance rate	75%	25%
Total direct mean hospital costs	$29,363	$36,808
Average daily hospital costs	$2,669	$2,831
Probability of mechanical ventilation	24%	31%
Probability of patient mortality	18%	23%
Probability of intensive care unit admission	40%	42%
Average intensive care unit length of stay (days)	2	3
Average hospital length of stay (days)	11	13
Probability of vasopressor use	17%	21%
Additional per patient new method cost	$250	$250

Note: All costs are expressed in US$.

Table 2 Expected benefits of new, faster fluid delivery method per 500 patients

Variable	Expected benefit
Reduction in expected facility costs	US $1,569,131
Reduction in patient deaths	10
Reduction in total hospital days	455
Reduction in number of patients admitted to intensive care unit	5
Reduction in total intensive care unit days	121
Reduction in number of patients requiring vasopressors	11
Reduction in number of patients requiring mechanical ventilation	17

Table 3 One-way sensitivity analysis

Model variable	Range	Base case assumption	Conservative assumption	New method cost saving with conservative assumption?
Average LOs for patient not receiving bundle compliant care	8–18 days	13 days	8 days	Yes
Average reduction in LOs for patient receiving bundle compliant care	1–4 days	2 days	1 day	Yes
Under current practices, % of time facility achieves bundle compliant care	26%–53%	26%	53%	Yes
% of time that non-compliance with fluid delivery is the cause of bundle non-compliant care	65%–98%	82%	65%	Yes
% of time that new method use will change bundle non-compliant fluid delivery to bundle compliant	50%–90%	75%	50%	Yes
Mean per-patient cost savings enabled by bundle compliant care	$6,328–$8,562	$7,445	$6,328	Yes

Note: All costs are expressed in US$.

Abbreviation: LOS, length of stay.

Table S1 Fluid delivery flow rates

Gauge	mL/min			P-value
	Pressure bag	Push-pull	New method
16	120	125	218	0.003
18	96	110	192	<0.001
20	80	101	223	<0.001
22	46	84	193	<0.001
CVC	47	72	126	<0.001

Abbreviation: CVC, central venous catheter.