Cost-benefit analysis of exchange transfusion for acute bilirubin encephalopathy / 重庆医学

ABSTRACT

Objective To assess the cost-benefit of exchange transfusion(ET ) in the treatment of different severity of acute bili-rubin encephalopathy(ABE) .Methods Retrospective analysis was carried out on the clinical data of 137 ABE from January 2009 to December 2010 .The enrolled neonates were divided into four groups by ABE severity and interventions:40 neonates in Group SE (Subtle ABE with ET ) ,29 in Group SNE (Subtle ABE without ET ) ,49 in Group ME (Moderate to advanced ABE with ET ) ,and 19 in Group MNE (Moderate to advanced ABE without ET ) .Results The Total Serum Bilirubin (TSB) levels ,the ratio of TSB and plasma albumin (B/A) ,the proportion of neonatal hemolysis disease and the hospitalization costs per capita in Group SE were significantly higher than those in Group SNE (P0 .05) .Morbidity of the severe adverse events associated with ET in Group ME ,12 .2% was 2 .4 times to that of Group SE ,5 .0% .Conclusion ET is worth of the first-line approach rescuing subtle ABE .However ,ET is needed to be weighted the advantages and disadvantages before performed on moderate or advanced ABE .It is necessary to implement phototherapy among neonates with pathologic jaundice ,which is crucial for diminishing mortality and mor-bidity of ABE and lowering medical resource consumption .