Wos İndeksli Yayınlar Koleksiyonu

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search.filters.applied.f.publicationcategory: search.filters.publicationcategory.Makale - Uluslararası Hakemli DergiSubject: search.filters.subject.Oxygen saturation

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    Cost-Effectiveness Analysis of Remdesivir Treatment in COVID-19 Patients Requiring Low-Flow Oxygen Therapy: Payer Perspective in Turkey
    (2021) Oksuz, Ergun; Malhan, Simten; Gonen, Mustafa Sait; Kutlubay, Zekayi; Keskindemirci, Yilmaz; Jarett, James; Sahin, Toros; Ozcagli, Gokcem; Bilgic, Ahmet; Bibilik, Merve Ozlem; Tabak, Ozlem; 0000-0002-5723-5965; 34379304; K-8238-2012
    Introduction This study aims to evaluate the cost-effectiveness of remdesivir compared to other existing therapies (SoC) in Turkey to treat COVID-19 patients hospitalized with < 94% saturation and low-flow oxygen therapy (LFOT) requirement. Methods We compared remdesivir as the treatment for COVID-19 with the treatments in the Turkish treatment guidelines. Analyses were performed using data from 78 hospitalized COVID-19 patients with SpO(2) < 94% who received LFOT in a tertiary healthcare facility. COVID-19 episode costs were calculated for 78 patients considering the cost of modeled remdesivir treatment in the same group from the payer's perspective. The incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) was calculated for remdesivir versus the SoC for the population identified. For Turkey, a reimbursement threshold value between USD 8599 (1 x per capita gross domestic product-GDP) and USD 25.797 (3 x GDP) per QALY was used. Results In the remdesivir arm, the length of hospital stay (LOS) was 3 days shorter than the SOC. The low ventilator requirement in the remdesivir arm was one factor that decreased the QALY disutility value. In patients who were transferred to intensive care unit (ICU) from the ward, the mean LOS was 17.3 days (SD 13.6), and the mean cost of stay was USD 155.3/day (SD 168.0), while in patients who were admitted to ICU at baseline, the mean LOS was 13.1 days (SD 13.7), and the mean cost of stay was USD 207.9/day (SD 133.6). The mean cost of episode per patient was USD 3461.1 (SD 2259.8) in the remdesivir arm and USD 3538.9 (SD 3296.0) in the SOC arm. Incremental QALYs were estimated at 0.174. Remdesivir treatment was determined to be cost saving vs. SoC. Conclusions Remdesivir, which results in shorter LOS and lower rates of intubation requirements in ICU patients than existing therapies, is associated with higher QALYs and lower costs, dominating SoC in patients with SpO(2) < 94% who require oxygen support.
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    Hypoxia parameters, physical variables, and severity of obstructive sleep apnea
    (2016) Avci, Suat; Avci, Aynur Yilmaz; Lakadamyali, Huseyin; Aydin, Erdinc; 0000-0001-9004-9382; 0000-0001-6864-7378; 0000-0003-2155-8014; F-6770-2019; AAJ-2379-2021; O-3636-2018
    Objective: To determine the relation between hypoxia and physical parameters in patients who had different levels of severity of obstructive sleep apnea (OSA). Methods: This was a retrospective, cross-sectional study of 259 men who were evaluated with overnight polysomnography. Severity of OSA was graded based on the apnea-hypopnea index (AHI): normal/simple snoring (n=31); mild OSA (n=70); moderate OSA (n=63); severe OSA (n=95). Patients with different severity were divided into subgroups, based on having the lowest or highest values of the total sleep time with oxygen saturation <90% (ST90) or minimum oxygen saturation (min SaO(2)). Results: Median AHI was 20.4 events/hour. Univariate analysis showed that ST90 was correlated with AHI (r=0.772; p <= 0.001) and Epworth sleepiness scale (ESS) (r=0.344; p <= 0.001), and min SaO(2) was inversely correlated with AHI (r=-0.748; p <= 0.001) and ESS (r=-0.319; p <= 0.001). Multivariate linear regression showed that ST90 was independently associated with AHI, ESS, and neck circumference, and min SaO(2) was independently inversely associated with AHI, ESS, and body mass index (BMI). In patients who had severe OSA, the subgroups which had lowest and highest min SaO(2) differed significantly in BMI, modified Mallampati score, neck and waist circumferences, and ret-roglossal Muller grade. In patients with percentage of sleep time with oxygen saturation below 90% (CT90) <10%, the upper limit of ST90 was 36 minutes and corresponded to 70% lower limit of min SaO(2). Conclusion: Hypoxia parameters show significant variation in OSA severity categories. None of the physical parameters had clinically useful relations with hypoxia parameters in OSA patients except patients who had severe OSA.