OBJECTIVES

: The risk of hospital deaths caused by trauma is increased in patients with abnormal levels of activated prothrombin time (PT) (>14 seconds), which constitutes 25% of patients who reach ER. The results of this test can take even three hours or at least 15 minutes in the hospital laboratory. Test strips CoaguChek Pro II can measure PT in 1 minute, which allows an earlier detection of patients with this characteristic. A complete economic evaluation from the payer perspective was developed to compare the PT test strips CoaguChek Pro II to the hospital laboratory test, which is the available alternative in the Mexican National Formulary.

METHODS

: A cost-effectiveness study, considering Mexican patients with penetrating trauma in ER as target population, was developed. In order to quantify alive patients with abnormal (primary outcome measure) and normal levels of PT, a decision-tree model was built using high quality evidence from a systematic review and costs published by public health institutions. The time until the PT result was obtained with each alternative was chosen as the time horizon. Sensitivity analysis were performed on the variables that could generate uncertainty.

RESULTS

: PT test strips detect a higher number of patients with abnormal levels of PT (23 vs 11.8) and normal levels of PT (62.1 Vs 41.1), in a hypothetical cohort of 100 patients, versus hospital laboratory tests. The additional cost with the use of PT test strips is $704.57 MXN, which suggests that the use of PT test strips is a very cost-effective alternative. Robustness of the model was confirmed with sensitivity analysis, where modification of uncertainty parameters did not change the high cost-effectiveness of PT test strips.

CONCLUSIONS: The use of PT test strips CoaguChek Pro II in patients with penetrating trauma in ER is a cost-effective option in comparison to the hospital laboratory tests