預測不停跳冠狀動脈繞道手術醫療費用

Predict Beating Heart Coronary Artery Bypass Surgery Direct Costs

陳淑美(Shu-Mei Chen) ； 劉立(Li Lu):陳益祥(Yih-Sharng Chen)

《中華民國急救加護醫學會雜誌》 15卷4期 (2004/12) Pp. 139-147

https://doi.org/10.30018/JECCM.200412.0001

摘要

Objective: In the last two decades evolutions of case-mix in heart surgery from mortality risk to complication risk has been observed in many centers. In spite of the increase in survival rate, an increase of the incidence of postoperative complications led to longer stay and more cost in medical issue. The aim of this study is apply additive EuroScore risk stratification model predict direct medical costs.
Methods: 364 consecutive beating heating heart coronary artery bypass graft surgery between November 2001and June 2003were enrolled with the addictive EuroScore risk model. Direct costs variable were retrospectively collected. The multivariance analysis was used to find independently associated with total direct costs.
Result: The study included 364beating heart coronary artery bypass-only operations. The average age was 65±10 years (range 40 to 88 years). most patients were men (76% versus 24%). The crude in hospital mortality was 3.75%, average EuroScore was 6.80±0.23. The mean total length of stay was 18±10.Ac-cording to EuroScore 61 patients (16.14%) were at low risk, 126 (33.3%) at medium, and 191(50.53%) at high risk. Costs were significantly and correlation with length of stay R^2=0.55 (P＜0.001); and costs were also significantly and correlation with EuroScore risk with R^2=0.55 (P＜0.001) and an increase of each single EuroScore risk score then the total direct costs increases 0.3%.
Conclusions: In this study, we can demonstrate EuroScore can be applied in beating heart coronary bypass as well as the conventional coronary artery bypass. The EuroSocre risk algorithm had a statistics significantly power to predict beating heart coronary artery bypass-only direct costs.

關鍵字

EuroScore ； 不停跳冠狀動脈繞道手術 ； 直接醫療費用

並列摘要

Objective: In the last two decades evolutions of case-mix in heart surgery from mortality risk to complication risk has been observed in many centers. In spite of the increase in survival rate, an increase of the incidence of postoperative complications led to longer stay and more cost in medical issue. The aim of this study is apply additive EuroScore risk stratification model predict direct medical costs.
Methods: 364 consecutive beating heating heart coronary artery bypass graft surgery between November 2001and June 2003were enrolled with the addictive EuroScore risk model. Direct costs variable were retrospectively collected. The multivariance analysis was used to find independently associated with total direct costs.
Result: The study included 364beating heart coronary artery bypass-only operations. The average age was 65±10 years (range 40 to 88 years). most patients were men (76% versus 24%). The crude in hospital mortality was 3.75%, average EuroScore was 6.80±0.23. The mean total length of stay was 18±10.Ac-cording to EuroScore 61 patients (16.14%) were at low risk, 126 (33.3%) at medium, and 191(50.53%) at high risk. Costs were significantly and correlation with length of stay R^2=0.55 (P＜0.001); and costs were also significantly and correlation with EuroScore risk with R^2=0.55 (P＜0.001) and an increase of each single EuroScore risk score then the total direct costs increases 0.3%.
Conclusions: In this study, we can demonstrate EuroScore can be applied in beating heart coronary bypass as well as the conventional coronary artery bypass. The EuroSocre risk algorithm had a statistics significantly power to predict beating heart coronary artery bypass-only direct costs.

並列關鍵字

EuroScore ； beating heart coronary artery bypass ； direct cost