Cost-Effectiveness of the Sucralfate Technetium 99m isotope Labelled Esophageal Scan to Assessesophageal Injury in Children after Caustic Ingestion
Journal Title: Emergency Medicine – Open Journal - Year 2014, Vol 1, Issue 1
Abstract
Background: Ingestion of caustic material by children is a considerable health problem. The 99mTc-labelled sucralfate esophageal scan proved to be an accurate method to identify injury to the esophagus after caustic substance ingestion. The purpose of this study was to calculate the cost-effectiveness of a sucralfate scan as compared to the gold standard of using endoscopy under general anesthesia. A secondary outcome was to assess the positive predictive value of the sucralfate scan. Methods: A 10-year retrospective medical folder audit was conducted of all children admitted to our hospital with a history of caustic ingestion who underwent a sucralfate scan to identify evidence of caustic esophageal injury/inflammation. The patients who had a negative sucralfate scan were assessed as having no significant injury and were discharged without further investigation or management. The patients with a positive result went for a subsequent endoscopy. Results: 234 patients were included. The total costs saved by performing a sucralfate scan only were R 446, 964.00 (South African Rand) in 234 patients. The positive predictive value of performing a sucralfate scan is 47.3%. Conclusion: A sucralfate scan as primary diagnostic method for caustic injury proved to be cost-effective and with less chance of complications.
Authors and Affiliations
Arjan Sebastiaan
Keywords
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- EP ID EP546135
- DOI 10.17140/EMOJ-1-105
- Views 165
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