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Preoperative determinants of postoperative costs associated with coronary artery bypass graft surgery.

Publication ,  Journal Article
Smith, LR; Milano, CA; Molter, BS; Elbeery, JR; Sabiston, DC; Smith, PK
Published in: Circulation
November 1994

BACKGROUND: Procedure-related costs are of increasing concern in selecting the appropriate procedure for the treatment of coronary artery disease (CAD). METHODS AND RESULTS: To determine what preoperative factors influence total postoperative hospital costs, data on 604 coronary artery bypass graft surgery (CABG) patients from 1990 to 1991 were analyzed. Professional fees were excluded. Hospital costs were computed by multiplying patient charges by the Medicare cost-to-charge ratio used in determining federal reimbursement. Median postoperative cost was $12,912 (range $7100 to $259,546). Data were analyzed with a semiparametric regression model. Patients dying in the hospital were censored at time of death. There were significant differences among surgeons in costs but no significant differences in operative mortality. Significant risk factors for increased cost after adjusting for surgeon were: older age (P < .0001), lower left ventricular ejection fraction (P < .0001), prior CABG (P < .0001), female sex (P < .0049), no prior percutaneous transluminal coronary angioplasty (P < .0091), increased degree of CAD (P < .0102), black race (P < .0190), and diabetes (P < .032). CONCLUSIONS: These results suggest that preoperative characteristics have important economic and medical implications. Surgeons should compare their management strategies on the basis of data analysis to determine the most effective practice with regard to mortality and cost.

Duke Scholars

Published In

Circulation

ISSN

0009-7322

Publication Date

November 1994

Volume

90

Issue

5 Pt 2

Start / End Page

II124 / II128

Location

United States

Related Subject Headings

  • Stroke Volume
  • Sex Factors
  • Risk Factors
  • Postoperative Care
  • North Carolina
  • Middle Aged
  • Male
  • Logistic Models
  • Humans
  • Hospitals, University
 

Citation

APA
Chicago
ICMJE
MLA
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Smith, L. R., Milano, C. A., Molter, B. S., Elbeery, J. R., Sabiston, D. C., & Smith, P. K. (1994). Preoperative determinants of postoperative costs associated with coronary artery bypass graft surgery. Circulation, 90(5 Pt 2), II124–II128.
Smith, L. R., C. A. Milano, B. S. Molter, J. R. Elbeery, D. C. Sabiston, and P. K. Smith. “Preoperative determinants of postoperative costs associated with coronary artery bypass graft surgery.Circulation 90, no. 5 Pt 2 (November 1994): II124–28.
Smith LR, Milano CA, Molter BS, Elbeery JR, Sabiston DC, Smith PK. Preoperative determinants of postoperative costs associated with coronary artery bypass graft surgery. Circulation. 1994 Nov;90(5 Pt 2):II124–8.
Smith, L. R., et al. “Preoperative determinants of postoperative costs associated with coronary artery bypass graft surgery.Circulation, vol. 90, no. 5 Pt 2, Nov. 1994, pp. II124–28.
Smith LR, Milano CA, Molter BS, Elbeery JR, Sabiston DC, Smith PK. Preoperative determinants of postoperative costs associated with coronary artery bypass graft surgery. Circulation. 1994 Nov;90(5 Pt 2):II124–II128.

Published In

Circulation

ISSN

0009-7322

Publication Date

November 1994

Volume

90

Issue

5 Pt 2

Start / End Page

II124 / II128

Location

United States

Related Subject Headings

  • Stroke Volume
  • Sex Factors
  • Risk Factors
  • Postoperative Care
  • North Carolina
  • Middle Aged
  • Male
  • Logistic Models
  • Humans
  • Hospitals, University