Table 2.
Clinical and economic outcomes associated with increased BAL usage, base case
| Year (% BAL usage) | ||||||
|---|---|---|---|---|---|---|
| Current (5%) | Year 1 (9%) | Year 2 (15%) | Year 3 (25%) | Year 4 (44%) | Year 5 (75%) | |
| Complications, % of SIRS patients (n/montha) | ||||||
| Death | 2.8 (1) | 2.8 (1) | 2.6 (1) | 2.5 (1) | 2.2 (1) | 1.6 (1) |
| 90-day readmission | 16.2 (7) | 16.1 (7) | 15.9 (7) | 15.5 (6) | 14.8 (6) | 13.6 (6) |
| Sepsis | 9.9 (4) | 9.7 (4) | 9.5 (4) | 9.0 (4) | 8.3 (3) | 7.0 (3) |
| Pneumonia | 5.5 (2) | 5.4 (2) | 5.2 (2) | 4.8 (2) | 4.2 (2) | 3.1 (1) |
| Cardiac dysrhythmia | 10.3 (4) | 10.2 (4) | 10.0 (4) | 9.6 (4) | 9.0 (4) | 7.9 (3) |
| Cardiac stress (MI/ACS) | 6.1 (3) | 6.0 (3) | 5.7 (2) | 5.3 (2) | 4.5 (2) | 3.1 (1) |
| Heart failure | 3.5 (1) | 3.4 (1) | 3.3 (1) | 3.1 (1) | 2.8 (1) | 2.2 (1) |
| Acute respiratory failure | 5.3 (2) | 5.2 (2) | 5.1 (2) | 4.9 (2) | 4.6 (2) | 4.0 (2) |
| Mg2+ replacement | 3.9 (2) | 3.9 (2) | 3.8 (2) | 3.6 (2) | 3.3 (1) | 2.8 (1) |
| K+ replacement | 13.2 (6) | 13.0 (5) | 12.6 (5) | 12.1 (5) | 11.1 (5) | 9.3 (4) |
| Economic outcomes (US$) | ||||||
| Attributable cost | ||||||
| LOS | 568,123 | 558,669 | 542,419 | 514,490 | 466,487 | 383,979 |
| Medication | 279,718 | 275,139 | 267,275 | 253,778 | 230,639 | 191,039 |
| Procedure | 105,414 | 103,673 | 100,680 | 95,537 | 86,696 | 71,501 |
| Professional services | 399,897 | 392,940 | 380,983 | 360,432 | 325,108 | 264,396 |
| Diagnostic | 402,524 | 395,819 | 384,296 | 364,489 | 330,447 | 271,935 |
| 3-day (72 h) fluid cost | 5312 | 5516 | 5866 | 6468 | 7504 | 9284 |
| Total—hospitalb | ||||||
| Total annual cost | 1,760,987 | 1,731,755 | 1,681,519 | 1,595,194 | 1,446,880 | 1,192,135 |
| Total annual savings | 0 | 29,232 | 79,468 | 165,793 | 314,107 | 568,852 |
| Total cumulative savings | 29,232 | 108,700 | 274,492 | 588,599 | 1,157,452 | |
| Total—pharmacyc | ||||||
| Total annual cost | 285,030 | 280,654 | 273,141 | 260,247 | 238,142 | 200,323 |
| Total annual savings | 0 | 4375 | 11,889 | 24,783 | 46,887 | 84,707 |
| Total cumulative savings | 4375 | 16,264 | 41,048 | 87,935 | 172,641 | |
ACS acute coronary syndrome, BAL calcium-free balanced crystalloid solution, LOS length of stay, MI myocardial infarction, SIRS systemic inflammatory response syndrome, US$ United States dollars
a n/month rounded to nearest unit
bIncludes LOS, medication, procedure, professional services, diagnostic, and 3-day fluid costs
cIncludes medication and 3-day fluid costs