Emergency Abdominal Aortic Aneurysm Repair with a Preferential Endovascular Strategy: Mortality and Cost-Effectiveness Analysis
Purpose: To assess mortality and treatment costs of a new management protocol with preferential use of emergency endovascular aneurysm repair (eEVAR) for acute abdominal aortic aneurysm (AAA). Methods: From September 2003 until February 2005, 49 consecutive patients (45 men; mean age 71 years) with...
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Published in | Journal of endovascular therapy Vol. 14; no. 6; pp. 777 - 784 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Los Angeles, CA
SAGE Publications
01.12.2007
Allen Press Inc |
Subjects | |
Online Access | Get full text |
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Abstract | Purpose:
To assess mortality and treatment costs of a new management protocol with preferential use of emergency endovascular aneurysm repair (eEVAR) for acute abdominal aortic aneurysm (AAA).
Methods:
From September 2003 until February 2005, 49 consecutive patients (45 men; mean age 71 years) with acute AAA were entered into a prospective study of a new management protocol that featured preferential use of eEVAR (n=18); patients with unsuitable anatomy or who were hemodynamically unstable underwent open repair (n=31). Mortality data and costs of treatment were compared in this mixed prospective group to a historical control group consisting of 147 patients (128 men; mean age 71 years) who underwent open repair from January 1998 to December 2001. All direct medical costs were included from the moment of admission until discharge from the hospital.
Results:
Mortality in the mixed prospective group (18%) was lower than in the historical control group (31%), but the difference did not reach statistical significance (p=0.099). The mean total cost in the mixed prospective group was €17,164 compared to €21,084 in the historical open repair group (p=0.255).
Conclusion:
A preferential eEVAR protocol for acute AAA can decrease mortality and does not increase overall costs during initial treatment, but larger studies are needed to determine if these trends are statistically significant. |
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AbstractList | PURPOSETo assess mortality and treatment costs of a new management protocol with preferential use of emergency endovascular aneurysm repair (eEVAR) for acute abdominal aortic aneurysm (AAA).METHODSFrom September 2003 until February 2005, 49 consecutive patients (45 men; mean age 71 years) with acute AAA were entered into a prospective study of a new management protocol that featured preferential use of eEVAR (n=18); patients with unsuitable anatomy or who were hemodynamically unstable underwent open repair (n=31). Mortality data and costs of treatment were compared in this mixed prospective group to a historical control group consisting of 147 patients (128 men; mean age 71 years) who underwent open repair from January 1998 to December 2001. All direct medical costs were included from the moment of admission until discharge from the hospital.RESULTSMortality in the mixed prospective group (18%) was lower than in the historical control group (31%), but the difference did not reach statistical significance (p=0.099). The mean total cost in the mixed prospective group was 17,164 euro compared to 21,084 euro in the historical open repair group (p=0.255).CONCLUSIONA preferential eEVAR protocol for acute AAA can decrease mortality and does not increase overall costs during initial treatment, but larger studies are needed to determine if these trends are statistically significant. To assess mortality and treatment costs of a new management protocol with preferential use of emergency endovascular aneurysm repair (eEVAR) for acute abdominal aortic aneurysm (AAA). From September 2003 until February 2005, 49 consecutive patients (45 men; mean age 71 years) with acute AAA were entered into a prospective study of a new management protocol that featured preferential use of eEVAR (n=18); patients with unsuitable anatomy or who were hemodynamically unstable underwent open repair (n=31). Mortality data and costs of treatment were compared in this mixed prospective group to a historical control group consisting of 147 patients (128 men; mean age 71 years) who underwent open repair from January 1998 to December 2001. All direct medical costs were included from the moment of admission until discharge from the hospital. Mortality in the mixed prospective group (18%) was lower than in the historical control group (31%), but the difference did not reach statistical significance (p=0.099). The mean total cost in the mixed prospective group was 17,164 euro compared to 21,084 euro in the historical open repair group (p=0.255). A preferential eEVAR protocol for acute AAA can decrease mortality and does not increase overall costs during initial treatment, but larger studies are needed to determine if these trends are statistically significant. To assess mortality and treatment costs of a new management protocol with preferential use of emergency endovascular aneurysm repair (eEVAR) for acute abdominal aortic aneurysm (AAA). From September 2003 until February 2005, 49 consecutive patients (45 men; mean age 71 years) with acute AAA were entered into a prospective study of a new management protocol that featured preferential use of eEVAR (n=18); patients with unsuitable anatomy or who were hemodynamically unstable underwent open repair (n=31). Mortality data and costs of treatment were compared in this mixed prospective group to a historical control group consisting of 147 patients (128 men; mean age 71 years) who underwent open repair from January 1998 to December 2001. All direct medical costs were included from the moment of admission until discharge from the hospital. Mortality in the mixed prospective group (18%) was lower than in the historical control group (31%), but the difference did not reach statistical significance (p=0.099). The mean total cost in the mixed prospective group was euro17,164 compared to euro21,084 in the historical open repair group (p=0.255). A preferential eEVAR protocol for acute AAA can decrease mortality and does not increase overall costs during initial treatment, but larger studies are needed to determine if these trends are statistically significant. Purpose: To assess mortality and treatment costs of a new management protocol with preferential use of emergency endovascular aneurysm repair (eEVAR) for acute abdominal aortic aneurysm (AAA). Methods: From September 2003 until February 2005, 49 consecutive patients (45 men; mean age 71 years) with acute AAA were entered into a prospective study of a new management protocol that featured preferential use of eEVAR (n=18); patients with unsuitable anatomy or who were hemodynamically unstable underwent open repair (n=31). Mortality data and costs of treatment were compared in this mixed prospective group to a historical control group consisting of 147 patients (128 men; mean age 71 years) who underwent open repair from January 1998 to December 2001. All direct medical costs were included from the moment of admission until discharge from the hospital. Results: Mortality in the mixed prospective group (18%) was lower than in the historical control group (31%), but the difference did not reach statistical significance (p=0.099). The mean total cost in the mixed prospective group was €17,164 compared to €21,084 in the historical open repair group (p=0.255). Conclusion: A preferential eEVAR protocol for acute AAA can decrease mortality and does not increase overall costs during initial treatment, but larger studies are needed to determine if these trends are statistically significant. |
Author | Tielliu, Ignace F. Zeebregts, Clark J. Oranen, Bjorn I. Kapma, Marten R. Groen, Henk van der Hilst, Christian S. Verhoeven, Eric L. Prins, Ted R. van den Dungen, Jan J. |
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CitedBy_id | crossref_primary_10_3400_avd_sa09001 crossref_primary_10_1007_s10049_017_0279_5 crossref_primary_10_1016_j_avsg_2014_03_017 crossref_primary_10_1016_j_avsg_2018_08_091 crossref_primary_10_1016_j_jvs_2010_10_072 crossref_primary_10_1016_j_jvs_2015_01_034 crossref_primary_10_1258_vasc_2011_oa0312 crossref_primary_10_1016_j_jvs_2010_01_087 crossref_primary_10_1016_j_jvs_2008_07_054 crossref_primary_10_1007_s00772_017_0277_4 crossref_primary_10_1016_j_jvs_2008_11_002 crossref_primary_10_1583_09_2941_1 crossref_primary_10_1007_s11936_009_0014_8 crossref_primary_10_1111_ans_16586 |
Cites_doi | 10.1016/j.ejvs.2006.05.016 10.1053/ejvs.2002.1972 10.1177/152660280200900603 10.1016/j.jvs.2006.07.048 10.1046/j.1365-2168.2002.02122.x 10.1016/S1078-5884(03)00346-0 10.1067/mva.2000.105959 10.1016/j.ejvs.2005.01.007 10.1177/152660280301000307 10.1053/ejvs.2001.1513 10.1016/j.jvs.2006.01.035 10.1007/s100169900308 10.1016/j.jvs.2005.02.023 10.1177/152660280301000308 10.1001/jama.276.14.1172 10.1016/j.jvs.2005.07.039 10.1148/radiol.2403051005 10.1016/S1072-7515(99)00051-4 10.1007/s10016-001-0242-1 10.1016/j.jvs.2005.05.047 10.1053/ejvs.2002.1928 |
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To assess mortality and treatment costs of a new management protocol with preferential use of emergency endovascular aneurysm repair (eEVAR) for acute... To assess mortality and treatment costs of a new management protocol with preferential use of emergency endovascular aneurysm repair (eEVAR) for acute... PURPOSETo assess mortality and treatment costs of a new management protocol with preferential use of emergency endovascular aneurysm repair (eEVAR) for acute... |
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SubjectTerms | Acute Disease Aged Aneurysms Aortic Aneurysm, Abdominal - complications Aortic Aneurysm, Abdominal - economics Aortic Aneurysm, Abdominal - mortality Aortic Aneurysm, Abdominal - surgery Aortic Rupture - economics Aortic Rupture - etiology Aortic Rupture - mortality Aortic Rupture - surgery Clinical Protocols Clinical trials Cost-Benefit Analysis Emergency Medical Services - economics Female Hospital Costs Humans Intensive care Male Minimally Invasive Surgical Procedures - economics Mortality Program Evaluation Prospective Studies Surgery Treatment Outcome Vascular Surgical Procedures - adverse effects Vascular Surgical Procedures - economics |
Title | Emergency Abdominal Aortic Aneurysm Repair with a Preferential Endovascular Strategy: Mortality and Cost-Effectiveness Analysis |
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