Improving outcomes for SSI and thrombectomy could have environmental benefits

The NHS faces a new challenge – it needs to continue providing world-class healthcare while striving to meet its net zero carbon goal. New research has demonstrated that it is possible to reduce environmental impact by improving patient outcomes in two areas: reducing surgical site infections across the NHS¹ and achieving first pass recanalisation in mechanical thrombectomy.²

The research was presented at The International Society of Pharmaeconomic and Outcomes Research (ISPOR) European conference in December by Mesut Kocaman, EMEA Health & Economics Market Access Manager for Johnson & Johnson Medical Devices. Environmental impact models were used to analyse the influence treatment options can have on sustainability, keeping in mind the NHS’s objective to reach net zero carbon emissions by 2040.

The first study explored the impact of surgical site infections (SSIs) across NHS England – demonstrating SSIs were associated with 10 additional days in hospital, 4.1 additional outpatient appointments, and 22% more A&E visits compared with patients without SSIs. Due to the additional resources required, the analysis demonstrated reducing one SSI could save 0.58 tonnes of CO2e (equivalent to two return flights from London to Rome), 5m³ of direct water use and 0.06 tonnes of waste. The annual cost to NHS England of SSI-associated environmental impact was estimated to be £2.67million.

The second study focused on mechanical thrombectomy – a procedure which uses a mechanical thrombectomy device to remove a clot from the brain during acute ischemic stroke. Previous studies have demonstrated that achieving complete or near complete reperfusion (modified Thrombolysis in Cerebral Infarction (mTICI) grade 2c-3) after a single pass can result in improved clinical outcomes. The new study showed that the decrease in resource utilisation by achieving mTICI 2c-3 after a single pass (first pass recanalisation) led to a 134 kg drop in CO₂e and a reduction of 13 kg of waste compared to the patients who achieved the same result after multiple passes. Achieving a 40% rate of first pass recanalisation could save as much as 51 tonnes of waste each year and 536 tonnes of CO₂e, equivalent to 2,500 round trip flights from London to Milan.

The full results can be found here for surgical site infections and here for mechanical thrombectomy.

References:

1. Kocaman M, Galvain T. The Cost Analysis of the Environmental Impacts of Surgical Site Infection from the Perspective of NHS England. Value in Health, Volume 24, Issue 12, S2 (December 2021)
2. Kocaman M, Taylor H. The Environmental Impact of the First Pass Effect in Mechanical Thrombectomy in the NHS. Value in Health, Volume 24, Issue 12, S2 (December 2021)