| Autor: |
John Allen, Mark Hanson, John Elliott, Kingsley Annan, Murat Tuzcu, Kim Brown, Patrick L. Whitlow, Nowa Omoigui, Brian P. Griffin |
| Rok vydání: |
1995 |
| Předmět: |
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| Zdroj: |
Journal of the American College of Cardiology. 25(2) |
| ISSN: |
0735-1097 |
| DOI: |
10.1016/0735-1097(95)93197-k |
| Popis: |
Between January 1992 and December 1993, 46 Inoue Mitral Commissurotomies (IMV) were performed as part of a Multicenter Investigation. In the same period, 19 IMV-eligible open mitral valvuloplasties (OMV) were performed for mitral stenosis. There were no differences in baseline characteristics (p = NS): Age (mean) Female Echo score (mean) Valve area (mean) IMV 51.4 ± 12.01 87.0% 7.1 ± 15 1.1 cm2 OMV 53.6 ± 12.9 94.7% 77 ± 25 1.1 cm2 93.5% of IMV were successful without valve surgery. Median costs (in 1993 dollars) using the Transition Systems Inc. accounting method. and length of stay (LOS) were higher for OMV than IMV (p l 0.001). Deaths and Strokes were similar: Death Stroke LOS (days) Cost ($) IMV 2.2% 0.0% 1 5,210 OMV 5.3% 0.0% 7 19,692 Correlates of IMV cost in multivariable stepwise regression analysis were: Mitral valve replacement p = 0.0001 Hospital delay g 24 hours prior to IMV P = 0.0035 Final trans-mitral gradient p = 0.0263 After controlling for LOS, intra-procedural transesophageal echocardiography predicted higher cost (p = 0.006). In conclusion, IMV is an effective short-stay cost minimizing strategy in appropriate patients. Cost savings can be obtained by expeditiously achieving a low residual gradient while avoiding mitral valve replacement. The cost-benefit of routine transesophageal echocardiography requires further study. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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