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Article: A randomized prospective study of the cost-effectiveness of the conventional spike, O-set, and UVXD techniques in continuous ambulatory peritoneal dialysis

TitleA randomized prospective study of the cost-effectiveness of the conventional spike, O-set, and UVXD techniques in continuous ambulatory peritoneal dialysis
Authors
Issue Date1994
PublisherMultimed, Inc. The Journal's web site is located at http://pdiconnect.com
Citation
Peritoneal Dialysis International, 1994, v. 14 n. 3, p. 255-260 How to Cite?
AbstractObjective: To compare the clinical outcome and cost-effectiveness of three techniques for continuous ambulatory peritoneal dialysis (CAPD): the conventional spike technique (C), the O-set (O), and UVXD (U, ultraviolet irradiation connection box). Design: A randomized and prospective comparison of three CAPD techniques. Setting: A tertiary referral and a satellite dialysis center. Patients: One hundred patients with end-stage renal failure between 10 and 70 years of age, with good hand-eye coordination and not anticipated to receive a living related transplant within 6 months. Interventions: Patients were randomized by referral to a table of random numbers to perform one of the three CAPD techniques. Main Outcome Measures: Training time, details of peritonitis and exit-site infection (ESI) including the costs of antibiotic treatment, outpatient visits, hospital stays, technique, and patient survival were analyzed after a minimum follow-up period of one year. Results: There were 38, 31, and 31 patients in groups C, O, and U, respectively, and the total observation periods were 838, 802, and 745 patient-months, respectively. The peritonitis rates for C, O, and U were 21.5, 30.8, and 29.8 patient-months/episode, respectively. The corresponding ESI rates were 16.4, 14.9, and 24 patient-months/episode, respectively. When the time from the commencement of CAPD to the first infection was expressed using the Kaplan-Meier life table analysis, 39.5%, 67.7%, and 61.3% of patients in Groups C, O, and U were free from peritonitis at one year (p = 0.088). The corresponding figures for ESI were 52.6%, 48.4%, and 61.3% (p = 0.35). There was no significant difference in technique survival in the three treatment groups. An analysis of the costs related to the use of antibiotics, outpatient visits, and hospital stays necessary for the treatment of peritonitis and ESI and those related to training time, additional equipment, and consumables required for the three CAPD techniques showed that, overall, the cost in O was the lowest, followed by U and C (U.S. $158, $170, and $179 per patient-month, respectively). Conclusion: It was concluded that the O-set is a more cost-effective CAPD technique than UVXD, while both are more cost-effective than the conventional spike technique.
Persistent Identifierhttp://hdl.handle.net/10722/162026
ISSN
2015 Impact Factor: 1.298
2015 SCImago Journal Rankings: 0.683
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorCheng, IKPen_US
dc.contributor.authorChan, CYen_US
dc.contributor.authorCheng, SWen_US
dc.contributor.authorPoon, JFMen_US
dc.contributor.authorJi, YLen_US
dc.contributor.authorLo, WKen_US
dc.contributor.authorChan, DTMen_US
dc.date.accessioned2012-09-05T05:16:45Z-
dc.date.available2012-09-05T05:16:45Z-
dc.date.issued1994en_US
dc.identifier.citationPeritoneal Dialysis International, 1994, v. 14 n. 3, p. 255-260en_US
dc.identifier.issn0896-8608en_US
dc.identifier.urihttp://hdl.handle.net/10722/162026-
dc.description.abstractObjective: To compare the clinical outcome and cost-effectiveness of three techniques for continuous ambulatory peritoneal dialysis (CAPD): the conventional spike technique (C), the O-set (O), and UVXD (U, ultraviolet irradiation connection box). Design: A randomized and prospective comparison of three CAPD techniques. Setting: A tertiary referral and a satellite dialysis center. Patients: One hundred patients with end-stage renal failure between 10 and 70 years of age, with good hand-eye coordination and not anticipated to receive a living related transplant within 6 months. Interventions: Patients were randomized by referral to a table of random numbers to perform one of the three CAPD techniques. Main Outcome Measures: Training time, details of peritonitis and exit-site infection (ESI) including the costs of antibiotic treatment, outpatient visits, hospital stays, technique, and patient survival were analyzed after a minimum follow-up period of one year. Results: There were 38, 31, and 31 patients in groups C, O, and U, respectively, and the total observation periods were 838, 802, and 745 patient-months, respectively. The peritonitis rates for C, O, and U were 21.5, 30.8, and 29.8 patient-months/episode, respectively. The corresponding ESI rates were 16.4, 14.9, and 24 patient-months/episode, respectively. When the time from the commencement of CAPD to the first infection was expressed using the Kaplan-Meier life table analysis, 39.5%, 67.7%, and 61.3% of patients in Groups C, O, and U were free from peritonitis at one year (p = 0.088). The corresponding figures for ESI were 52.6%, 48.4%, and 61.3% (p = 0.35). There was no significant difference in technique survival in the three treatment groups. An analysis of the costs related to the use of antibiotics, outpatient visits, and hospital stays necessary for the treatment of peritonitis and ESI and those related to training time, additional equipment, and consumables required for the three CAPD techniques showed that, overall, the cost in O was the lowest, followed by U and C (U.S. $158, $170, and $179 per patient-month, respectively). Conclusion: It was concluded that the O-set is a more cost-effective CAPD technique than UVXD, while both are more cost-effective than the conventional spike technique.en_US
dc.languageengen_US
dc.publisherMultimed, Inc. The Journal's web site is located at http://pdiconnect.comen_US
dc.relation.ispartofPeritoneal Dialysis Internationalen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshBacterial Infections - Etiologyen_US
dc.subject.meshCatheterization - Adverse Effectsen_US
dc.subject.meshChilden_US
dc.subject.meshCost-Benefit Analysisen_US
dc.subject.meshCosts And Cost Analysisen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOutcome Assessment (Health Care)en_US
dc.subject.meshPeritoneal Dialysis, Continuous Ambulatory - Adverse Effects - Economics - Methodsen_US
dc.subject.meshPeritonitis - Etiologyen_US
dc.subject.meshProspective Studiesen_US
dc.titleA randomized prospective study of the cost-effectiveness of the conventional spike, O-set, and UVXD techniques in continuous ambulatory peritoneal dialysisen_US
dc.typeArticleen_US
dc.identifier.emailChan, DTM:dtmchan@hku.hken_US
dc.identifier.authorityChan, DTM=rp00394en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid7948238-
dc.identifier.scopuseid_2-s2.0-0027993462en_US
dc.identifier.volume14en_US
dc.identifier.issue3en_US
dc.identifier.spage255en_US
dc.identifier.epage260en_US
dc.identifier.isiWOS:A1994PC28900011-
dc.publisher.placeCanadaen_US
dc.identifier.scopusauthoridCheng, IKP=7102537483en_US
dc.identifier.scopusauthoridChan, CY=24517697500en_US
dc.identifier.scopusauthoridCheng, SW=7404684783en_US
dc.identifier.scopusauthoridPoon, JFM=16936614800en_US
dc.identifier.scopusauthoridJi, YL=18535766200en_US
dc.identifier.scopusauthoridLo, WK=7201502414en_US
dc.identifier.scopusauthoridChan, DTM=7402687700en_US

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