Comparative Effectiveness of Autologous Platelet Gel in Coronary Artery Bypass Grafting Surgery: A Formal Decision Analysis

Abstract

Coronary artery bypass grafting (CABG) surgery is one of the most common operations performed in the United States. Despite the frequency of this operation, however, it is estimated that surgical site infections (SSIs) occur with a cumulative incidence between 0.5%-7% among CABG patients. In a time of increasing pressure for health care to improve in quality, hospitals must prevent such infections or risk being required to pay for the expenses incurred to treat those infections that arise. Autologous Platelet Gel (APG) has presented itself as an effective method by which to prevent SSIs through the escalation of the immunological response and the growth of new tissue. This decision analysis aims to answer the clinical question: Should Autologous Platelet Gel be used in Coronary Artery Bypass Grafting procedures along with the current standard of care (SOC)? A decision analytic model was used to determine the total expected mortality that is produced from the use of the standard of care (SOC) alone and the SOC along with APG, giving respect to (a) severity of the SSI; (b) development of deep SSI from a superficial SSI; (c) surgical revision of the SSI; and (d) the cause of mortality.