Several studies suggest that hemodynamic optimization therapies can reduce complications, the length of hospital stay and costs. However, Brazilian data are scarce. Therefore, the objective of this analysis was to evaluate whether the improvement demonstrated by hemodynamic optimization therapy in surgical patients could result in lower costs from the perspective of the Brazilian public unified health system. A meta-analysis was performed comparing surgical patients who underwent hemodynamic optimization therapy (intervention) with patients who underwent standard therapy (control) in terms of complications and hospital costs. The cost-effectiveness analysis evaluated the clinical and financial benefits of hemodynamic optimization protocols for surgical patients. The analysis considered the clinical outcomes of randomized studies published in the last 20 years that involved surgeries and hemodynamic optimization therapy. Indirect costs (equipment depreciation, estate and management activities) were not included in the analysis. A total of 21 clinical trials with a total of 4872 surgical patients were selected. Comparison of the intervention and control groups showed lower rates of infectious (RR = 0.66; 95% CI = 0.58–0.74), renal (RR = 0.68; 95% CI = 0.54–0.87), and cardiovascular (RR = 0.87; 95% CI = 0.76–0.99) complications and a nonstatistically significant lower rate of respiratory complications (RR = 0.82; 95% CI = 0.67–1.02). There was no difference in mortality (RR = 1.02; 95% CI = 0.80–1.3) between groups. In the analysis of total costs, the intervention group showed a cost reduction of R$396,024.83-BRL ($90,161.38-USD) for every 1000 patients treated compared to the control group. The patients in the intervention group showed greater effectiveness, with 1.0 fewer days in the intensive care unit and hospital. In addition, there were 333 fewer patients with complications, with a consequent reduction of R$1,630,341.47-BRL ($371,173.27-USD) for every 1000 patients treated. Hemodynamic optimization therapy is cost-effective and would increase the efficiency of and decrease the burden of the Brazilian public health system.

中文翻译：

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围手术期血流动力学优化疗法对手术患者的影响：经济研究和荟萃分析。

多项研究表明，血液动力学优化疗法可减少并发症，缩短住院时间并降低成本。但是，巴西的数据很少。因此，该分析的目的是从巴西公共统一卫生系统的角度评估通过血液动力学优化疗法对外科手术患者证明的改善是否可以降低成本。进行荟萃分析，比较接受血液动力学优化治疗（干预）的手术患者和接受标准治疗（对照）的患者的并发症和住院费用。成本效益分析评估了针对手术患者的血液动力学优化方案的临床和财务收益。该分析考虑了最近20年来发表的涉及手术和血液动力学优化治疗的随机研究的临床结果。间接费用（设备折旧，财产和管理活动）未包括在分析中。总共选择了21个临床试验，共计4872名外科手术患者。干预组和对照组的比较显示出较低的感染率（RR = 0.66； 95％CI = 0.58–0.74），肾脏（RR = 0.68； 95％CI = 0.54–0.87）和心血管（RR = 0.87； 95％） CI = 0.76-0.99）并发症和呼吸系统并发症的发生率无统计学意义（RR = 0.82； 95％CI = 0.67-1.02）。两组之间的死亡率无差异（RR = 1.02； 95％CI = 0.80–1.3）。在总成本分析中，干预组显示成本降低了396,024雷亚尔。与对照组相比，每1000例患者治疗83-BRL（90,161.38美元）。干预组的患者显示出更高的疗效，在重症监护室和医院的住院天数减少了1.0天。此外，并发症患者减少了333人，因此，每治疗1000名患者减少了1,630,341.47巴西雷亚尔（371,173.27美元）。血液动力学优化疗法具有成本效益，可以提高巴西公共卫生系统的效率并减轻其负担。每治疗1000名患者，收入47-BRL（$ 371,173.27-USD）。血液动力学优化疗法具有成本效益，可以提高巴西公共卫生系统的效率并减轻其负担。每治疗1000名患者，收入47-BRL（$ 371,173.27-USD）。血液动力学优化疗法具有成本效益，可以提高巴西公共卫生系统的效率并减轻其负担。