The economic impact of cytomegalovirus infection after liver transplantation.
The economic impact of cytomegalovirus infection after liver transplantation.
复制标题
肝移植后巨细胞病毒感染的经济影响。
DOI：
10.1097/00007890-200002150-00008
复制
发表时间：
2000
期刊：
影响因子：
6.2
通讯作者：
C. Payá
中科院分区：
文献类型：
--
作者：
W. Kim;A. Badley;R. Wiesner;M. Porayko;E. Seaberg;M. Keating;R. Evans;E. Dickson;R. Krom;C. Payá
背景
我们研究了巨细胞病毒(CMV)病的经济影响以及抗病毒预防对肝移植受者的有效减少。
方法
采用前瞻性随机对照试验，比较口服阿昔洛韦800 mg，每日4次，共120天；静脉注射更昔洛韦5 mg/kg，每12小时一次，共14天，然后再静脉注射阿昔洛韦106天，对所收集的机构电荷数据进行分析。
结果
发生巨细胞病毒病的肝移植受者的费用(中位数：148,300美元)明显高于那些出现无症状巨细胞病毒感染的患者(119,600美元)或没有巨细胞病毒感染的患者(114,100美元)(P<；0.01)。多元线性回归分析表明，巨细胞病毒病与费用增加49%有关，与其他影响住院费用增加的因素无关。在接受CMV血清阳性捐献器官的CMV血清阴性患者中，与预防ACV相比，预防GCV与显著降低费用有关(分别为113,900美元对153,300美元；P=0.02)。
结论
巨细胞病毒病是肝移植相关资源利用率增加的独立危险因素。使用有效的预防性抗病毒方案可节省卫生保健资源，特别是在罹患巨细胞病毒病的高危患者。
BACKGROUND
We studied the economic impact of cytomegalovirus (CMV) disease and its effective reduction with antiviral prophylaxis in liver transplant recipients.
METHOD
Analysis of institutional charge data accumulated during a prospective, randomized, controlled trial comparing oral acyclovir 800 mg four times daily for 120 days (ACV) and intravenous ganciclovir 5 mg/kg every 12 h for 14 days followed by ACV for 106 days (GCV) was performed.
RESULTS
Liver transplant recipients who developed CMV disease had significantly higher charges (median: $148,300) than those who developed asymptomatic CMV infection ($119,600) or experienced no CMV infection ($114,100) (P<0.01). A multiple linear regression analysis indicated that CMV disease is associated with a 49% increase in charges, independent of other factors influencing increased hospitalization charges. In CMV-seronegative patients who received a CMV-seropositive donor organ, GCV prophylaxis was associated with a significant reduction in charges, as compared to ACV prophylaxis ($113,900 vs. $153,300, respectively; P=0.02).
CONCLUSIONS
CMV disease is an independent risk factor for increased resource utilization associated with liver transplantation. The use of an effective prophylactic antiviral regimen provides savings in health care resources, particularly in patients at high risk for developing CMV disease.
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DOI：
--
发表时间：
1995
期刊：
Clinical transplants.
影响因子：
--
作者：
Kim,WR;Therneau,TM;Dickson,ER;Evans,RW
通讯作者：
Evans,RW
影响因子：
5.9
作者：
George, MJ;Snydman, DR;Rubin, RH
通讯作者：
Rubin, RH
肝移植中巨细胞病毒感染的预防：一项比较更昔洛韦和阿昔洛韦组合与阿昔洛韦的随机试验。
影响因子：
6.2
作者：
Badley,AD;Seaberg,EC;Porayko,MK;Wiesner,RH;Keating,MR;Wilhelm,MP;Walker,RC;Patel,R;Marshall,WF;DeBernardi,M;Zetterman,R;Steers,JL;Paya,CV
通讯作者：
Paya,CV
巨细胞病毒病与原位肝移植受者的费用和住院时间增加有关。
影响因子：
6.2
作者：
Falagas,ME;Arbo,M;Ruthazer,R;Griffith,JL;Werner,BG;Rohrer,R;Freeman,R;Lewis,WD;Snydman,DR
通讯作者：
Snydman,DR