Intravenous Fluid Treatments for Ebola Patients: The Risk and the Reward

• Activity Number: 119 - SPEED: Government and Health Policy
• Type: Contributed
• Date/Time: Monday, July 30, 2018 : 8:30 AM to 10:20 AM
• Sponsor: Health Policy Statistics Section
• Author(s): Derrick Yam* and Tao Liu and Adam Levine and Adam Aluisio and Shiromi Peters and Suzanne Averill and Stephen Kennedy and Fodey Sahr and Jillian Peters and Daniel Cho
• Companies: Brown University and Brown University and Brown University and Brown University and International Medical Corps and International Medical Corps and Ministry of Health, Liberia and Sierra Leone Ministry of Defence and Brown University and Brown University
• Keywords: Causal Inference; Matching; Ebola; Marginal Structural Models

Abstract

During the Ebola outbreak in Western Africa between 2014 and 2015, data was systematically collected by clinicians, at Ebola Treatment Units (ETUs) operated by International Medical Corps, on the treatments provided to patients with Ebola Virus Disease (EVD) and their mortality outcomes. In this study, we investigate the causal effects of intravenous fluid (IVF) treatment on mortality outcome in EVD patients receiving care at five ETUs from two countries during the epidemic. Using causal inference methods, we match EVD patients who received IVF treatment to those that did not based on their propensity score (the probability of receiving treatment) and their viral load. Results allude to increased survival rates from IVF treatment for Ebola patients with a low viral load, however, increased mortality rates resulting from IVF treatment for Ebola patients with a high viral load. Future work will extend this investigation into a time dependent analysis of IVF treatment controlling for initiation time and duration time using marginal structural models.