The Environmental Impact of the First Pass Effect in Mechanical Thrombectomy in the NHS
Author(s)
Kocaman M1, Taylor H2
1Johnson & Johnson Medical SAS, Issy les Moulineaux, France, 2Johnson & Johnson Medical Limited, Berkshire, UK
Presentation Documents
OBJECTIVES: First Pass Effect (FPE), a measure of the ability of a mechanical thrombectomy (MT) device to restore complete or near-complete reperfusion (mTICI 2c-3) in a single pass of the device through a clot, is an independent predictor of good functional outcome. FPE results in improved clinical outcomes and healthcare resource utilisation. We aim to appraise the environmental impacts of the reductions in healthcare resource utilisation with FPE. METHODS: An environmental impact model was developed. Clinical and resource data were obtained from the post-hoc analysis of an ARISE II multi-country prospective trial. Sustainability data was obtained from the Sustainable Care Pathways Guidance, which was created by the Sustainable Healthcare Coalition, of which the NHS Sustainable Development Unit is a member. Patients were limited to those in whom mTICI 2c-3 was achieved to avoid any selection bias. Outcomes examined were greenhouse gas emissions and waste resulting from the hospital stay. RESULTS: Achieving FPE led to savings of 3.1 standard bed days and 0.2 intensive care unit days compared to mTICI 2c-3 achieved after multiple passes. The estimated environmental savings based on the reduction in resource utilisation for FPE were 134 kg CO₂e and 13 kg waste per procedure. It is estimated that 10,000 patients per year are eligible for MT in the UK. Achieving 40% mTICI 2c-3 after FPE could save 536 tonnes of CO₂e and 51 tonnes of waste each year in the UK due to reductions in length of hospital stay; which is the equivalent of the carbon emissions of 2,500 round trip flights from London to Milan. CONCLUSIONS: The NHS is aiming to reach net zero carbon emissions by 2040, with an 80% reduction by 2028-2032. Achieving high successful reperfusion rates and reduced length of hospital stay with FPE in MT could contribute to NHS targets.
Conference/Value in Health Info
2021-11, ISPOR Europe 2021, Copenhagen, Denmark
Value in Health, Volume 24, Issue 12, S2 (December 2021)
Code
POSC294
Topic
Medical Technologies
Topic Subcategory
Medical Devices
Disease
Neurological Disorders