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Dexmedetomidine versus standard care sedation with propofol or midazolam in intensive care: an economic evaluation

Overview of attention for article published in Critical Care, December 2015
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (94th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

Mentioned by

news
1 news outlet
blogs
1 blog
twitter
24 tweeters
facebook
4 Facebook pages
wikipedia
2 Wikipedia pages
googleplus
1 Google+ user

Citations

dimensions_citation
54 Dimensions

Readers on

mendeley
138 Mendeley
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Title
Dexmedetomidine versus standard care sedation with propofol or midazolam in intensive care: an economic evaluation
Published in
Critical Care, December 2015
DOI 10.1186/s13054-015-0787-y
Pubmed ID
Authors

Heidi Turunen, Stephan M Jakob, Esko Ruokonen, Kirsi-Maija Kaukonen, Toni Sarapohja, Marjo Apajasalo, Jukka Takala

Abstract

Dexmedetomidine was shown in two European randomized double-blind double-dummy trials (PRODEX and MIDEX) to be non-inferior to propofol and midazolam in maintaining target sedation levels in mechanically ventilated intensive care unit (ICU) patients. Additionally, dexmedetomidine shortened the time to extubation versus both standard sedatives, suggesting that it may reduce ICU resource needs and thus lower ICU costs. Considering resource utilization data from these two trials, we performed a secondary, cost-minimization analysis assessing the economics of dexmedetomidine versus standard care sedation. The total ICU costs associated with each study sedative were calculated on the basis of total study sedative consumption and the number of days patients remained intubated, required non-invasive ventilation, or required ICU care without mechanical ventilation. The daily unit costs for these three consecutive ICU periods were set to decline toward discharge, reflecting the observed reduction in mean daily Therapeutic Intervention Scoring System (TISS) points between the periods. A number of additional sensitivity analyses were performed, including one in which the total ICU costs were based on the cumulative sum of daily TISS points over the ICU period, and two further scenarios, with declining direct variable daily costs only. Based on pooled data from both trials, sedation with dexmedetomidine resulted in lower total ICU costs than using the standard sedatives, with a difference of €2,656 in the median (interquartile range) total ICU costs-€11,864 (€7,070 to €23,457) versus €14,520 (€7,871 to €26,254)-and €1,649 in the mean total ICU costs. The median (mean) total ICU costs with dexmedetomidine compared with those of propofol or midazolam were €1,292 (€747) and €3,573 (€2,536) lower, respectively. The result was robust, indicating lower costs with dexmedetomidine in all sensitivity analyses, including those in which only direct variable ICU costs were considered. The likelihood of dexmedetomidine resulting in lower total ICU costs compared with pooled standard care was 91.0% (72.4% versus propofol and 98.0% versus midazolam). From an economic point of view, dexmedetomidine appears to be a preferable option compared with standard sedatives for providing light to moderate ICU sedation exceeding 24 hours. The savings potential results primarily from shorter time to extubation. ClinicalTrials.gov NCT00479661 (PRODEX), NCT00481312 (MIDEX).

Twitter Demographics

The data shown below were collected from the profiles of 24 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 138 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 3 2%
Mexico 1 <1%
Canada 1 <1%
Spain 1 <1%
Unknown 132 96%

Demographic breakdown

Readers by professional status Count As %
Researcher 22 16%
Student > Master 17 12%
Other 16 12%
Student > Ph. D. Student 13 9%
Student > Postgraduate 12 9%
Other 38 28%
Unknown 20 14%
Readers by discipline Count As %
Medicine and Dentistry 76 55%
Pharmacology, Toxicology and Pharmaceutical Science 11 8%
Nursing and Health Professions 7 5%
Biochemistry, Genetics and Molecular Biology 3 2%
Business, Management and Accounting 2 1%
Other 9 7%
Unknown 30 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 34. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 July 2021.
All research outputs
#848,844
of 19,846,165 outputs
Outputs from Critical Care
#728
of 5,642 outputs
Outputs of similar age
#12,245
of 227,478 outputs
Outputs of similar age from Critical Care
#1
of 32 outputs
Altmetric has tracked 19,846,165 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,642 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 17.9. This one has done well, scoring higher than 87% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 227,478 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 94% of its contemporaries.
We're also able to compare this research output to 32 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.