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Kidney Week

Abstract: TH-PO070

Cost Impact of an Immunomodulatory Selective Cytopheretic Device in Pediatrics (SCD-PED) in AKI Due to Sepsis (AKI-S)

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Kammerer, Jennifer A., SeaStar Medical, Inc, Denver, Colorado, United States
  • Kleinman, Nathan L., Kleinman Analytic Solutions LLC, Frisco, Texas, United States
  • Kleinman, Alec, Kleinman Analytic Solutions LLC, Frisco, Texas, United States
  • Chung, Kevin K., SeaStar Medical, Inc, Denver, Colorado, United States
  • Iyer, Sai Prasad N., SeaStar Medical, Inc, Denver, Colorado, United States
  • Thakar, Charuhas V., Queen's University Belfast, Belfast, United Kingdom
Background

Acute kidney injury (AKI) occurs in 3.9/1000 US pediatric hospitalizations—often with septicemia (OR 1.37 (1.32 to 1.43))—and requiring ICU care and continuous kidney replacement therapy (CKRT). Poor outcomes include prolonged stays, mechanical ventilation (MV), and up to 50% mortality. SCD-PED is an authorized humanitarian device for patients >10kg, age <22 years with AKI-S on CKRT. Using Kids’ Inpatient Database (KID) and SCD-PED study data, hospitalization costs are estimated.

Methods

KID extract (2019) included patients ages 1-20 years on CKRT. Modeled from hospital perspective were inputs for length of stay (LOS), age, gender, death at discharge, vasopressor use, MV, sepsis or AKI, total parenteral nutrition (TPN), mortality risk, SCD-PED cost/number used. Mean mortality was 45% in external controls and 27% on SCD-PED. Costs are adjusted to 2024 USD. Cost savings are derived from mortality benefit or simulated for 1-day reduction in LOS. Generalized linear regression was used to model costs. All variables were significant except gender and AKI.

Results

Mean hospitalization cost was $461,736 in KID controls, reflecting heterogenous, complex cases and costly burden. With continuous 6-day SCD-PED, savings from lower mortality is predicted for device price up to $4381. With theoretically lower LOS, further savings may be realized.

Conclusion

The SCD-PED is likely cost beneficial to implement with presumed survival benefit in critically ill pediatric AKI-S. Other benefits may include clinical value of lower mortality and costs from a) reduced total or ICU LOS, b) outcomes beyond hospitalization (avoided dialysis, renal recovery), and c) sepsis or readmission quality measurements.

SCD-PED Cost Model

Funding

  • Commercial Support – SeaStar Medical, Inc.