CONCLUSIONS: The use of an SpO2 threshold below 90% for deciding on hospitalization in infants with viral bronchiolitis living at high altitudes appear to be logical, secure, and cost-effective.
Expert Rev Pharmacoecon Outcomes Res. 2023 Mar 15. doi: 10.1080/14737167.2023.2192482. Online ahead of print.
ABSTRACT
BACKGROUND: There is evidence suggesting that exaggerated reliance on pulse oximetry (SpO2) and the use of arbitrary/inadequate thresholds of SpO2 might drive unnecessary hospitalizations for viral bronchiolitis, especially among high-altitude residents. The aim of the present study was to compare the cost-effectiveness of two oxygen SpO2 thresholds for deciding whether infants with viral bronchiolitis living at high altitudes need hospital admission or can be discharged to home.
METHODS: : A cost-effectiveness study was performed to compare the cost and clinical outcomes of two oxygen SpO2 thresholds, adjusted or not, to the altitude above the sea level of Bogota, Colombia (2640m), for deciding whether infants with viral bronchiolitis need hospitalization or can be discharged to home. The principal outcome was avoidance of hospital admission.
RESULTS: Compared to the use of an SpO2 threshold of 90%, using an SpO2 threshold of 85% in infants with viral bronchiolitis was associated with lower overall costs (US$130.4 vs. US$194.0 average cost per patient) and a higher probability of hospitalization avoided (0.7500 vs. 0.5900), thus leading to dominance.
CONCLUSIONS: The use of an SpO2 threshold below 90% for deciding on hospitalization in infants with viral bronchiolitis living at high altitudes appear to be logical, secure, and cost-effective.
PMID:36922366 | DOI:10.1080/14737167.2023.2192482
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