Cost effectiveness of tunneled double lumen to non-tunnel double lumen dialysis catheters.

摘要

Objectives: To ascertain the cost-effectiveness of tunneled catheters to nontunneledcatheter in dialysis patients of a tertiary care hospital. Study Design: Retrospectivecross-sectional study. Study Design: Department of Nephrology, Pak Emirates Military HospitalRawalpindi. Period: Jan 2016 to Jan 2019. Material & Methods: The sample populationcomprised of 500 patients, being divided into two groups and followed over a period of 03 yrs.Group A had tunneled double lumen and group B had non tunneled double lumen. Dialysiswas started on the same day in both groups. Both groups were compared in terms of costeffectiveness. Cost effectiveness included price of catheter, procedure cost, treatment ofinfection (if any), and change of catheter in case of catheter malfunction. The amount spent oneach patient was added and then an average was calculated. Results: Out of 600 patients, 300were in group A and 300 patients were in group B. The two groups were analogous in gender(male: 52.8% vs 57.8%, p=0.35)age (41 years vs 49 yrs, p=0.71) hypertension and diabetes asthe main causes of ESRD (51% vs 39%, p=0.08 and 32% vs 34%, p=0.38, respectively). Totalincurred cost of tunneled double lumen was Rs.19000.00, with average infection free patencytime being three months during which Arteriovenous fistula formed. In comparison, non-tunneleddouble lumen in 300 patients, average cost incurred was Rs.30000.00 including cost incurredon treating sepsis and in two –three insertions in few cases . There was no procedure relatedmortality. Conclusion: The cost-effectiveness of Tunneled double lumen catheters and clinicalbenefit of reduction in patency failures and also access related infections make them the firstchoice for dialysis patients in majority of dialysis centers of our country but large randomizedcontrol trials needed as the sample size quite less to detect a difference from the newer agents.