The realm of central nervous system infections (CNSIs) in postoperative neurosurgical patients presents a formidable challenge in the medical community, largely due to the need for rapid and accurate pathogen identification. Despite Metagenomic Next-Generation Sequencing (mNGS) technology showcasing remarkable advancements in pathogen detection speed and sensitivity, its economic value in critical care settings has not been robustly studied. This article delves into the clinical health economic benefits of utilizing mNGS over conventional pathogen culture methods in critical care, particularly after neurosurgical interventions.
Study Design and Methodology
Conducted at the Beijing Tiantan Hospital ICU, a prospective pilot study spanned from March 2023 to January 2024, encompassing 60 individuals diagnosed with CNSIs. Participants were randomly assigned either to an mNGS group or to a conventional pathogen culture group in equal proportions. For a thorough economic evaluation, the study employed a decision-tree model that relied on incremental cost-effectiveness ratios (ICERs) to compare the two diagnostic procedures. The model aimed to deduce the most financially prudent approach without compromising the speed and accuracy of diagnoses.
Key Findings
The results were telling: mNGS substantially enhanced diagnostic efficiency with a significantly reduced turnaround time, one day as opposed to five days (_P_<0.001). Additionally, there was a noteworthy reduction in anti-infective costs for mNGS (_A18,000 vs A23,000; _P_=0.02). Although the diagnostic costs were elevated for mNGS (_A4,000 vs A2,000; _P_<0.001), the ICER calculation of A36,700 for each additional timely diagnosis indicated cost-effectiveness when linked with China’s GDP-based willingness-to-pay (WTP) threshold.
Significantly, no marked differences were seen in hospital stay durations or overall expenditure between the two groups (_P_>0.05).
– mNGS significantly speeds up CNS pathogen detection.
– Lower anti-infective expenses are achieved through mNGS.
– Initial higher diagnostic costs of mNGS offset by broader cost-effectiveness.
– Hospital durations remain consistent irrespective of diagnostic method.
These findings illuminate the economic viability and enhanced clinical outcomes of mNGS for CNSIs post-neurosurgery in intensive care settings. As pathogen resistance continues to increase, rapid and precise identification becomes paramount, directly influencing patient management and antimicrobial usage. Medical professionals and policymakers should weigh the initial steep diagnostic costs of mNGS against its long-term financial and clinical benefits. A nuanced approach should factor in regional economic circumstances and healthcare practices to optimize the adoption of mNGS technology.
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