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• W4386041597 abstract "BACKGROUND CONTEXT Smoking has been described as an independent risk factor for postoperative complications and increased rates of pseudoarthrosis in adult spinal deformity (ASD) patients. To our knowledge, the cost-utility of implementing a smoking cessation program for ASD patients prior to undergoing spine deformity surgery has not been previously reported. PURPOSE This study aimed to perform a cost-effectiveness analysis of smoking cessation program for adult spinal deformity patients with plans of undergoing spinal surgery. STUDY DESIGN/SETTING Cost-effectiveness analysis. METHODS A decision-analysis model was built for a hypothetical adult patient with spinal deformity with plans of undergoing surgical intervention. A comprehensive review of the literature was performed to obtain event probabilities, costs and health utilities at each node. Health utilities were utilized to calculate Quality-Adjusted Life Years (QALYs). A base-case analysis was carried out to obtain the incremental cost and effectiveness (QALYs) of smoking cessation program prior to spine surgery. Probabilistic sensitivity analysis was performed to evaluate uncertainty in our model and obtain mean incremental costs, effectiveness, and net monetary benefits. One-way sensitivity analyses were also performed to identify the variables with the most impact on our model. RESULTS Use of smoking cessation program was favored as a strategy in 96.4% of the iterations. The mean incremental utility ratio for the smoking cessation program demonstrated higher benefit and lower cost while being lower than the willingness-to-pay threshold set at $150,000 per quality adjusted life years. The smoke cessation program was associated with a mean incremental net monetary benefit (INMB) of $15,387. One-way sensitivity analysis reported cost of revision surgery due to pseudoarthrosis and QALY of pseudoarthrosis. CONCLUSIONS Use of smoking cessation programs is a cost-effective strategy to reduce postoperative complications and rates of revision surgeries due to pseudoarthrosis. The use of smoking cessation programs should be considered as part of patient-case analysis. FDA Device/Drug Status This abstract does not discuss or include any applicable devices or drugs. Smoking has been described as an independent risk factor for postoperative complications and increased rates of pseudoarthrosis in adult spinal deformity (ASD) patients. To our knowledge, the cost-utility of implementing a smoking cessation program for ASD patients prior to undergoing spine deformity surgery has not been previously reported. This study aimed to perform a cost-effectiveness analysis of smoking cessation program for adult spinal deformity patients with plans of undergoing spinal surgery. Cost-effectiveness analysis. A decision-analysis model was built for a hypothetical adult patient with spinal deformity with plans of undergoing surgical intervention. A comprehensive review of the literature was performed to obtain event probabilities, costs and health utilities at each node. Health utilities were utilized to calculate Quality-Adjusted Life Years (QALYs). A base-case analysis was carried out to obtain the incremental cost and effectiveness (QALYs) of smoking cessation program prior to spine surgery. Probabilistic sensitivity analysis was performed to evaluate uncertainty in our model and obtain mean incremental costs, effectiveness, and net monetary benefits. One-way sensitivity analyses were also performed to identify the variables with the most impact on our model. Use of smoking cessation program was favored as a strategy in 96.4% of the iterations. The mean incremental utility ratio for the smoking cessation program demonstrated higher benefit and lower cost while being lower than the willingness-to-pay threshold set at $150,000 per quality adjusted life years. The smoke cessation program was associated with a mean incremental net monetary benefit (INMB) of $15,387. One-way sensitivity analysis reported cost of revision surgery due to pseudoarthrosis and QALY of pseudoarthrosis. Use of smoking cessation programs is a cost-effective strategy to reduce postoperative complications and rates of revision surgeries due to pseudoarthrosis. The use of smoking cessation programs should be considered as part of patient-case analysis." @default.
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• W4386041597 date "2023-09-01" @default.
• W4386041597 modified "2023-10-09" @default.
• W4386041597 title "P112. The cost effectiveness of smoking cessation program in patients undergoing spinal deformity surgery" @default.
• W4386041597 doi "https://doi.org/10.1016/j.spinee.2023.06.337" @default.
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