Comparison of perioperative costs with fast-track vs standard endovascular aneurysm repair
Comparison of perioperative costs with fast-track vs standard endovascular aneurysm repair
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DOI：
10.2147/vhrm.s210593
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发表时间：
2019-01-01
影响因子：
2.9
通讯作者：
Miller, Larry E.
中科院分区：
文献类型：
--
作者：
Krajcer, Zvonimir;Ramaiah, Venkatesh G.;Miller, Larry E.
背景：接受择期快速通道与标准血管内动脉瘤修复术 (EVAR) 的患者围术期医疗保健利用率和费用仍不清楚。方法：快速通道 EVAR 组包括接受 14 Fr 支架移植、双侧经皮通路治疗、无需全身麻醉或重症监护、第二天出院的患者。标准 EVAR 组是从 Medicare 行政索赔中确定的，使用匹配算法来调整患者特征的不平衡。医院结果包括手术室时间、重症监护监测、住院时间、二次干预和主要不良事件 (MAE)。从出院到出院后 30 天发生的围手术期结果包括 MAE、二次干预和无关的再入院。 结果：在 1000 名匹配患者（250 名快速通道患者；750 名标准患者）中，医院结果有利于快速通道 EVAR 组，包括更短的手术室时间（2.30 小时 vs 2.83 小时，P
Background: Perioperative health care utilization and costs in patients undergoing elective fast-track vs standard endovascular aneurysm repair (EVAR) remain unclear.Methods: The fast-track EVAR group included patients treated with a 14 Fr stent graft, bilateral percutaneous access, no general anesthesia or intensive care monitoring, and next-day hospital discharge. The standard EVAR group was identified from Medicare administrative claims using a matching algorithm to adjust for imbalances in patient characteristics. Hospital outcomes included operating room time, intensive care monitoring, hospital stay, secondary interventions, and major adverse events (MAEs). Perioperative outcomes occurring from hospital discharge to 30 days postdischarge included MAE, secondary interventions, and unrelated readmissions.Results: Among 1000 matched patients (250 fast-track; 750 standard), hospital outcomes favored the fast-track EVAR group, including shorter operating room time (2.30 vs 2.83 hrs, P