首页 | 本学科首页   官方微博 | 高级检索  
     


In-Hospital Costs and Costs of Complications of Chronic Total Occlusion Angioplasty: Insights From the OPEN-CTO Registry
Authors:Adam C. Salisbury  Dimitri Karmpaliotis  J. Aaron Grantham  James Sapontis  Qingrui Meng  Elizabeth A. Magnuson  Hemal Gada  William Lombardi  Jeffrey Moses  Haiyan Li  Suzanne V. Arnold  Suzanne J. Baron  John A. Spertus  David J. Cohen
Affiliation:1. Saint Luke’s Mid America Heart Institute, Kansas City, Missouri;2. University of Missouri–Kansas City, Kansas City, Missouri;3. Columbia University Medical Center and New York Presbyterian Hospital, New York, New York;4. Monash Heart, Melbourne, Australia;5. PinnacleHealth Cardiovascular Institute, Wormleysburg, Pennsylvania;6. University of Washington School of Medicine, Seattle, Washington
Abstract:

Objectives

The aim of this study was to describe the costs of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) and the association of complications during CTO PCI with costs and length of stay (LOS).

Background

CTO PCI generally requires more procedural resources and carries higher risk for complications than PCI of non-CTO vessels. The costs of CTO PCI using the hybrid approach have not been described, and no studies have examined the impact of complications on in-hospital costs and LOS in this population.

Methods

Costs were calculated for 964 patients in the 12-center OPEN-CTO (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion Hybrid Procedures) registry using prospectively collected resource utilization and billing data. Multivariate models were developed to estimate the incremental costs and LOS associated with complications. Attributable costs and LOS were calculated by multiplying the independent cost of each event by its frequency in the population.

Results

Mean costs for the index hospitalization were $17,048 ± 9,904; 14.5% of patients experienced at least 1 complication. Patients with complications had higher mean hospital costs (by $8,603) and LOS (by 1.5 days) than patients without complications. Seven complications were independently associated with increased costs and 6 with LOS; clinically significant perforation and myocardial infarction had the greatest attributable cost per patient. Overall, complications accounted for $911 per patient in hospital costs (5.3% of the total costs) and 0.2 days of additional LOS.

Conclusions

Complications have a significant impact on both LOS and in-hospital costs for patients undergoing CTO PCI. Methods to identify high-risk patients and develop strategies to prevent complications may reduce CTO PCI costs.
Keywords:angioplasty  chronic total occlusion  complications  cost  stable coronary artery disease  CAD  coronary artery disease  CI  confidence interval  CTO  chronic total occlusion  IQR  interquartile range  LOS  length of stay  PCI  percutaneous coronary intervention
本文献已被 ScienceDirect 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号