PP66. Endoluminal Infrarenal Aortic Aneurysm Repair: A Costly Endeavor for Low Risk Patients

医学 腔内修复术 腹主动脉瘤 外科 主动脉瘤 回顾性队列研究 动脉瘤 并发症 腹部外科 共病 死亡率 内科学
作者
Michael M. McNally,Steven C. Agle,Samuel A. Hayes,Sheila K. Kori,William F. Curry,Christopher I. Jones,Frank M. Parker,William M. Bogey,Charles S. Powell,Michael C. Stoner
出处
期刊:Journal of Vascular Surgery [Elsevier BV]
卷期号:49 (5): S33-S34
标识
DOI:10.1016/j.jvs.2009.02.096
摘要

Since the FDA approval of endovascular aortic aneurysm repair (EVAR) devices, there has been a gradual transition from a physiologic to an anatomic criteria case selection. The economic implications of this evolving selection criteria have not been widely studied. The objective of this study is to investigate the cost-effectiveness of elective EVAR compared to OPEN abdominal aortic aneurysm (AAA) repair, in low and high risk patients. A retrospective analysis was performed reviewing all patients who underwent an elective AAA repair between 2004 and 2007. Clinical endpoints included postoperative stay, postoperative complications and 30-day mortality. Total hospital cost associated with the index procedure was obtained. The study population was divided into high (SVS score ≥ 8)and low risk (SVS score <8) surgical groups based on the SVS/AAVS medical comorbidity grading system. P < 0.05 was significant. During the study period, a total of 401 cases were identified, 43% (n = 173, SVS score 7.7 ± 0.25) EVAR and 57% (n = 228, SVS score 6.7 ± 0.32) OPEN. With the exception of ESRD (5.2%, n = 9 EVAR, 0% n = 0 OPEN, P < 0.01), the patient co-morbid profiles were not statistically different. Postoperative stay was less for EVAR (2.1 ± 0.2 days EVAR, 7.6 ± 0.4 days OPEN, P < 0.0001). For high risk patients (EVAR n = 88, OPEN n = 96), there was a trend towards higher 30-day mortality (1.1% EVAR vs 4.2% OPEN, P = 0.20) and a significantly higher complication rate (4.5% EVAR vs 15.6% OPEN, P = 0.013). The total hospital cost was significantly higher in the EVAR group ($35,903 ± 1156 EVAR vs $21,998 ± 1487 OPEN, P < 0.01). For the low risk cohort, there was no difference in morbidity and mortality despite higher total cost with EVAR ($33,758 ± 1120 EVAR vs $20,041 ± 1480 OPEN, P < 0.001). High risk OPEN AAA patients have a higher postoperative complication rate and show a trend in increased 30-day mortality compared to high risk EVAR patients. Low risk AAA repair patients exhibit a negligible difference between EVAR and OPEN regarding postoperative complications and mortality, which does not justify the significant healthcare cost difference between treatment groups. Based on these data, the policy of EVAR in low risk patients cannot be supported by clinical outcomes or financial measures.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
今天只做一件事完成签到,获得积分0
2秒前
PSC完成签到,获得积分10
3秒前
eueurhj发布了新的文献求助30
3秒前
小二郎应助迪克牛仔采纳,获得10
4秒前
一直向前发布了新的文献求助10
5秒前
明芬完成签到,获得积分10
8秒前
9秒前
123456完成签到,获得积分10
12秒前
结实的慕凝完成签到,获得积分10
14秒前
苗条小土豆完成签到,获得积分10
14秒前
flance完成签到 ,获得积分10
16秒前
17秒前
fanfan完成签到 ,获得积分10
19秒前
SkyTsai完成签到,获得积分10
19秒前
22秒前
23秒前
轻松的惜芹应助诚心谷南采纳,获得10
23秒前
天天快乐应助sml采纳,获得10
24秒前
26秒前
27秒前
27秒前
华仔应助sxx采纳,获得10
30秒前
YJ888发布了新的文献求助10
31秒前
32秒前
哼哼唧唧发布了新的文献求助10
32秒前
石大大发布了新的文献求助10
34秒前
huoguo完成签到,获得积分10
35秒前
小二郎应助完美芒果采纳,获得10
35秒前
Liufgui应助紫竹魔笛采纳,获得10
37秒前
38秒前
40秒前
Liufgui应助YJ888采纳,获得10
41秒前
赘婿应助麦子采纳,获得10
41秒前
42秒前
KK发布了新的文献求助10
42秒前
娟姐完成签到,获得积分10
43秒前
ding应助李朝富采纳,获得10
44秒前
桐桐应助学术蝗虫采纳,获得10
45秒前
杨桃发布了新的文献求助10
45秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989550
求助须知:如何正确求助?哪些是违规求助? 3531774
关于积分的说明 11254747
捐赠科研通 3270278
什么是DOI,文献DOI怎么找? 1804966
邀请新用户注册赠送积分活动 882125
科研通“疑难数据库(出版商)”最低求助积分说明 809176