Mid-term cost-effectiveness analysis of open and endovascular repair for ruptured abdominal aortic aneurysm  

Oleh:

Rollins, K. E. ; Shak, J. ; Ambler, G. K. ; Tang, T. Y. ; Hayes, P. D. ; Boyle, J. R.

Jenis: Article from Article - diterbitkan di jurnal ilmiah internasional
Dalam koleksi: BJS: British Journal of Surgery vol. 101 no. 03 (Feb. 2014), page 225-231.

Ketersediaan

Perpustakaan FK Nomor Panggil: B15.K.2014.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background Emergency endovascular repair (EVAR) for ruptured abdominal aortic aneurysm (rAAA) may have lower operative mortality rates than open surgical repair. Concerns remain that the early survival benefit after EVAR for rAAA may be offset by late reinterventions. The aim of this study was to compare reintervention rates and cost-effectiveness of EVAR and open repair for rAAA. Methods A retrospective analysis was undertaken of patients with rAAA undergoing EVAR or open repair over 6?years. A health economic model developed for the cost-effectiveness of elective EVAR was used in the emergency setting. Results Sixty-two patients (mean age 77·9?years) underwent EVAR and 85 (mean age 75·9?years) had open repair of rAAA. Median follow-up was 42 and 39?months respectively. There was no significant difference in 30-day mortality rates after EVAR and open repair (18 and 26 per cent respectively; P?=?0·243). Reintervention rates were also similar (32 and 31 per cent; P?=?0·701). The mean cost per patient was €26?725 for EVAR and €30?297 for open repair, and the cost per life-year gained was €7906 and €9933 respectively (P?=?0·561). Open repair had greater initial costs: longer procedural times (217 versus 178·5?min; P?

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