• Carlos E Rodriguez-Martinez, Monica P Sossa-Briceño, and Antonio BuendiaJeffersonJ0000-0003-2404-6612Department of Pharmacology and Toxicology, School of Medicine, Research Group in Pharmacology and Toxicology (INFARTO), Universidad de Antioquia, Medellín, Colombia..
• Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia.
• Curr Med Res Opin. 2022 Dec 1; 38 (12): 204720532047-2053.

ObjectivesThe objective of the current study was to evaluate the cost-effectiveness of two pulse oximetry (SpO2) thresholds to decide on hospital discharge when all other discharge criteria are met, in infants with viral bronchiolitis living at high altitudes.MethodsA decision analysis model was developed to estimate the cost-effectiveness of the use of an SpO2 threshold of 90% versus one of 85% for deciding whether infants hospitalized for viral bronchiolitis can be safely discharged to home, from a third-party payer's perspective. The main outcome was discharge to home at day 4 of the initial hospitalization. The time horizon was 28 days after discharge from hospital. We performed deterministic sensitivity analyses and probabilistic sensitivity analyses.ResultsCompared to the use of an SpO2 threshold of 90%, treating infants with viral bronchiolitis with the use of an SpO2 threshold of 85% resulted in lower total costs (US$119.39 vs. US$188.357 mean cost per patient) and a greater probability of discharge to home at day 4 of the initial hospitalization (0.8400 vs. 0.7600), therefore being a dominant strategy. Sensitivity analyses were in line with base case results.ConclusionsIn Bogota, a high-altitude city, in infants admitted for viral bronchiolitis, the use of an SpO2 threshold of 85% to decide on hospital discharge when all other discharge criteria are met is dominant because it entails a greater probability of discharge to home at day 4 of the initial hospitalization and generates fewer costs than the use of an SpO2 threshold of 90%.

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