Incremental cost of complications after TAVR and SAVR in contemporary clinical practice.

IF 3.5 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
American heart journal Pub Date : 2025-12-01 Epub Date: 2025-07-12 DOI:10.1016/j.ahj.2025.07.001
James E Harvey, Michael Ryan, Candace Gunnarsson, Soumya Chikermane, Suzanne J Baron
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引用次数: 0

Abstract

Background: Prior studies have demonstrated that peri-procedural complications are associated with increased healthcare costs after surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). Given the technological and procedural advances that have occurred in the management of aortic valve disease over the last decade, this study aims to understand the incremental cost of specific complications after SAVR and TAVR in contemporary practice.

Methods: Using the Medicare 100% standard analytic file, we identified all beneficiaries receiving SAVR or TAVR in the United States during fiscal year 2021. Specific complications were identified via ICD-10 codes. Multivariable analyses were performed to estimate the incremental cost and length of stay (LOS) for each complication. Attributable costs were calculated by adjusting the incremental cost of each complication for its incidence.

Results: The cost of an uncomplicated TAVR index hospitalization was $46,257 with LOS 2.2 days, while an uncomplicated SAVR cost $58,488 with LOS 8.1 days. The presence of any complication increased costs and LOS for TAVR ($66,601; 5.9 days) and SAVR ($88,900; 13.4 days). Prolonged ventilation was associated with the highest incremental cost for TAVR ($55,742), while pacemaker implantation had the highest attributable cost ($1,270). Prolonged ventilation accounted for the highest incremental ($69,728) and attributable ($2,580) cost associated with SAVR.

Conclusion: This study provides contemporary data on the incremental costs of specific peri-procedural complications associated with TAVR and SAVR. These findings can be used to develop targeted interventions to optimize healthcare resource utilization in patients undergoing aortic valve replacement.

当代临床TAVR和SAVR术后并发症的增量成本。
先前的研究表明,手术主动脉瓣置换术(SAVR)和经导管主动脉瓣置换术(TAVR)后术中并发症与医疗费用增加有关。鉴于过去十年来主动脉瓣疾病治疗技术和程序的进步,本研究旨在了解当代实践中SAVR和TAVR后特定并发症的增量成本。方法:使用医疗保险100%标准分析文件,我们确定了2021财年美国所有接受SAVR或TAVR的受益人。通过ICD-10代码确定特定并发症。进行多变量分析以估计每种并发症的增量成本和住院时间(LOS)。归因成本是通过调整每个并发症的发生率的增量成本来计算的。结果:单纯TAVR指数住院费用为46,257美元,住院时间为2.2天;单纯SAVR住院费用为58,488美元,住院时间为8.1天。任何并发症的存在增加了TAVR的费用和LOS ($66,601;5.9天)和SAVR ($88,900;13.4天)。延长通气与TAVR的最高增量成本相关(55,742美元),而起搏器植入的可归因成本最高(1,270美元)。延长通气与SAVR相关的增量成本(69,728美元)和可归因成本(2,580美元)最高。结论:本研究提供了与TAVR和SAVR相关的特定围手术期并发症的增量成本的当代数据。这些发现可用于制定有针对性的干预措施,以优化主动脉瓣置换术患者的医疗资源利用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
American heart journal
American heart journal 医学-心血管系统
CiteScore
8.20
自引率
2.10%
发文量
214
审稿时长
38 days
期刊介绍: The American Heart Journal will consider for publication suitable articles on topics pertaining to the broad discipline of cardiovascular disease. Our goal is to provide the reader primary investigation, scholarly review, and opinion concerning the practice of cardiovascular medicine. We especially encourage submission of 3 types of reports that are not frequently seen in cardiovascular journals: negative clinical studies, reports on study designs, and studies involving the organization of medical care. The Journal does not accept individual case reports or original articles involving bench laboratory or animal research.
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