Use of Nexobrid in the treatment of the Critically Burned patient. How much does it cost to treat 1% of burned skin surface? Is it cost-effective?
J.Baena; A. Arevalo; A.Bulla; A.Jimenez; D.Rivas; S.Valles; E.Novoa; A.Gracia;J.Serracanta; M.Baguena; JP.Barret
OBJECTIVE
To evaluated the cost-effectiveness of enzymatic debridement with Nexobrid in the critically burned patient who required surgical intervention (SI) during hospitalization.
METHODS
We evaluated critically burned patients admitted to the Burned Unit of the Vall d'Hebron University Hospital from 2019 to 2021. Consecutive cohort of burned patients who required invasive mechanical ventilation (IMV) or amines given their severity on admission is studied.
With a total of 82 patients, we excluded 17 patients that did not require SI and 3 patients that required hospitalization for more than 100 days.
We collected demographic data, severity scales, presence of inhalation injury (IH), percentage of Burn Skin Surface (%BSS), days of IMV and mortality.
For the evaluation of economic expenditure we collected the following data: need for tracheotomy, days of stay in Intensive Care Unit (ICU), need of blood products, grams of Nexobrid used and number of SI performed to calculate the cost required to treat each 1% of BSS.
RESULTS
Of 62 patients, 35 were treated with Nexobrid plus SI and 27 with SI alone. Of the Nexobrid group, 68.5 % were men, mean age 45.6 years, burn abbreviated severity index (ABSI) of 8.9, mean BSS 41.2 %. Sixteen patients had IH, 13 required tracheotomy and a mean of 16.7 days of IMV with a mean ICU stay of 24.2 days. Average consumption of 23.8 red blood cell concentrates (RBCC), 5.6 plasma concentrates (PC) and 1.3 platelet pool (PP) with an average of 3.3 interventions were performed per patient and an average consumption of 25 grams of Nexobrid per patient. 5 patients were deceased.
About the group with only SI, 70% are men with a mean age of 52 years, a ABSI of 7.9 and an average of 27.6 %BSS.  Of those 27 patients, 13 had IH, 9 required tracheotomy and a mean of 14.7 days of IMV. Mean ICU stay of 23.3 days with an average consumption of 23.3 (RBCC), 4.7 PC and 1.5 PP, requiring an average of 3.6 SI per patient. 8 patients were deceased.
The economic cost of Nexobrid group was 2054.8€/1% BSS compared to the group who just received surgical intervention which had a cost of 2800€/1% BSS.
CONCLUSIONS
Patients in the Nexobrid group have higher ABSI, higher %BSS, more days of stay in ICU and more days of IMV.
The economic cost to cure 1% of BSS was lower in the group where Nexobrid was used.

P.042 Use of Nexobrid in the treatment of the Critically Burned patient. How much does it cost to treat 1% of burned skin surface? Is it cost-effective?

Dear friends and colleagues,

We will be pleased to welcome you in Turin (Italy) for the 19th European Burns Association´s Congress in 2022. Italy is honored to hold the meeting of the European Burns Association for the second time, after Verona in 1995. Turin is easily reachable from everywhere in Europe, either travelling by car, train or choosing flight connections. During the meeting, held in the renewed industrial center of the main Italian historical automotive factory (i.e. Lingotto-FIAT), we will meet international burn specialists, focusing on standards of care, progresses in burn treatment, strategies to face disaster situations, with a special attention to education of younger colleagues. However, in your spare time, you might enjoy the sweet days of Italian late summer, simply wandering in the green parks and gardens along the two rivers which cross the city, or you might decide to discover the numerous art galleries, churches, palaces, libraries, walking across elegant squares and large boulevards, passing through centuries of art and history; finally, you may choose to immerse yourself in some of the most exciting museum experiences, such as the Cinema Museum and the Turin’s Egyptian museum.

Looking forward to seeing you all in Turin for the 19th European Association´s Congress in 2022!
Maurizio Stella, Congress President, Turin Burn Centre