Mortality,Morbidity, and Costs of Ruptured and Elective Abdominal Aortic Aneurysm Repairs in Nova Scotia,Canada |
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Authors: | Hall F Chew CK You Murray G Brown Benjamin E Heisler Pantelis Andreou |
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Institution: | (1) Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada, CA;(2) Division of Vascular Surgery, Department of Surgery, New Halifax Infirmary, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada, CA;(3) Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada, CA |
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Abstract: | Ruptured abdominal aortic aneurysms (RAAA) have a 78-94% mortality rate. If cost-effectiveness of screening programs for abdominal
aortic aneurysms (AAA) are to be assessed, direct costs for RAAA repairs and elective AAA (EAAA) repairs are required. This
study reports mortality, morbidity, and direct costs for RAAA and EAAA repairs in Nova Scotia in 1997-1998 and also compares
Nova Scotia and U.S. costs. We performed a retrospective study of 41 consecutive RAAA and 48 randomly selected EAAA patients.
Average total costs for RAAA repair were significantly greater than those for EAAA repair (direct costs: $15,854 vs. $9673;
direct plus overhead costs: $18,899 vs. $12,324 pricing in 1998 Canadian dollars]). Intensive care unit length of stay and
blood product usage were the most substantial direct cost differentials ($3593 and $2106). Direct cost for preoperative testing
and surveillance was greater in the EAAA group ($839 vs. $33). Estimates of U.S. in-hospital RAAA and EAAA repair costs are
more than 1.5 times Nova Scotia costs. Direct in-hospital RAAA repair costs are $6181 more than EAAA repair costs. These in-hospital
cost data are key cost elements required to assess the cost-effectiveness of various screening strategies for earlier detection
and monitoring of AAA within high-risk populations in Canada. Further studies are required to estimate cost per quality-adjusted-life-year
gained for various AAA screening and monitoring strategies in Canada. |
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