Table 1.
Summary of model inputs
| Hospital bed size | Value (%) | Source |
|---|---|---|
| SIRS frequency (% of patients) | ||
| 0–99 | 4.6 | Shaw et al. 2015 database outcomes analysis [16] |
| 100–199 | 4.7 | |
| 200–299 | 3.8 | |
| 300–499 | 2.7 | |
| ≥500 | 1.8 | |
| Average length of stay per patient | 4.62 days | Shaw et al. 2015 database outcomes analysis [16] |
| Complication | BALa | Salineb | Source |
|---|---|---|---|
| Complication frequency (% of SIRS patients; adjusted) | |||
| Death | 1.2 | 2.9 | Shaw et al. 2015 database outcomes analysis [16] |
| 90-day readmission | 12.7 | 16.4 | |
| Sepsis | 6.0 | 10.1 | |
| Pneumonia | 2.3 | 5.7 | |
| Cardiac dysrhythmia | 7.0 | 10.5 | |
| Cardiac stress (MI/ACS) | 2.1 | 6.4 | |
| Heart failure | 1.8 | 3.6 | |
| Acute respiratory failure | 3.5 | 5.3 | |
| Mg2+ replacement | 2.4 | 4.0 | |
| K+ replacement | 8.0 | 13.5 | |
| Complication | Cost (US$) | Source |
|---|---|---|
| Complication-associated cost (US$/episode)c | ||
| Sepsis | 12,955.87 | Elixhauser et al., 2011 [20], Medicare Inpatient Charge Data, 2014 [23] |
| Pneumonia | 2456.67 | Pfuntner et al., 2013b [22], Medicare Inpatient Charge Data, 2014 [23] |
| Cardiac dysrhythmia | 2808.41 | Pfuntner et al., 2013a [21], Medicare Inpatient Charge Data, 2014 [23] |
| Cardiac stress (MI/ACS) | 12,430.38 | Pfuntner et al., 2013b [22], Medicare Inpatient Charge Data, 2014 [23] |
| Heart failure | 3931.84 | Pfuntner et al., 2013b [22], Medicare Inpatient Charge Data, 2014 [23] |
| Acute respiratory failure | 16,769.62 | Pfuntner et al., 2013a [21], Medicare Inpatient Charge Data, 2014 [23] |
| Mg2+ replacement | 13.56 | Shaw et al. 2015 database outcomes analysis [16] |
| K+ replacement | 10.79 | Shaw et al. 2015 database outcomes analysis [16] |
| Complication | LOS | Medication | Procedure | Professional service | Diagnostic | Source |
|---|---|---|---|---|---|---|
| Attributable costs (% of total per-episode cost) | ||||||
| Sepsis | 33 | 20 | 6 | 17 | 24 | MS-DRG 2010 [24] |
| Pneumonia | 32 | 18 | 6 | 19 | 25 | MS-DRG 2010 [24] |
| Cardiac dysrhythmia | 36 | 13 | 5 | 21 | 24 | MS-DRG 2010 [24] |
| Cardiac stress | 31 | 11 | 6 | 31 | 21 | MS-DRG 2010 [24] |
| Heart failure | 37 | 11 | 5 | 21 | 26 | MS-DRG 2010 [24] |
| Acute respiratory failure | 31 | 16 | 6 | 25 | 21 | MS-DRG 2010 [24] |
| Fluid | Cost | Source |
|---|---|---|
| Per-liter fluid price (US$) | ||
| BAL | 11.46 | WAC, Micromedex Red Book, 2015 [14] |
| Ringer’s Lactate | 3.82 | WAC, Micromedex Red Book, 2015 [14] |
| 0.9% saline | 3.35 | WAC, Micromedex Red Book, 2015 [14] |
| 0.45% saline | 4.46 | WAC, Micromedex Red Book, 2015 [14] |
ACS acute coronary syndrome, BAL calcium-free balanced crystalloid solution, LOS length of stay, MI myocardial infarction, SIRS systemic inflammatory response syndrome, US$ United States dollars, WAC wholesale acquisition cost
aBAL usage reflects use of a combination of crystalloids in the 3 days following the SIRS event, calculated from weighted average volumes (BAL: 54.5%; 0.9% saline: 25.5%; Ringer’s Lactate: 17.0%; 0.45% saline: 1.7%)
bSaline usage reflects use of a combination of crystalloids in the 3 days following the SIRS event, calculated from weighted average volumes (0.9% saline: 76.0%; Ringer’s Lactate: 21.0%; 0.45% saline: 2.0%)
bPer-episode complication costs were based on costs reported in the literature [20–22] offset by additional reimbursement hospitals receive for patients with major complications/co-morbidities [23]