Abdulla A Damluji1, Mohammed S Al-Damluji2, Sydney Pomenti2, Tony J Zhang2, Mauricio G Cohen2, Raul D Mitrani2, Mauro Moscucci2, Robert J Myerburg1. 1. Sinai Hospital of Baltimore, LifeBridge Health Cardiovascular Institute, MD (A.A.D., M.M.). Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.D.). Department of Internal Medicine, University of Connecticut Health Center, Farmington (M.S.A.). Cardiovascular Division, University of Miami Miller School of Medicine, FL (S.P., T.J.Z., M.G.C., R.D.M., R.J.M.). University of Michigan Health System, Ann Arbor (M.M.). rmyerbur@med.miami.edu Abdulla.Damluji@jhu.edu. 2. Sinai Hospital of Baltimore, LifeBridge Health Cardiovascular Institute, MD (A.A.D., M.M.). Division of Cardiology, Johns Hopkins University, Baltimore, MD (A.A.D.). Department of Internal Medicine, University of Connecticut Health Center, Farmington (M.S.A.). Cardiovascular Division, University of Miami Miller School of Medicine, FL (S.P., T.J.Z., M.G.C., R.D.M., R.J.M.). University of Michigan Health System, Ann Arbor (M.M.).
Abstract
BACKGROUND: This study was designed to estimate the costs of index hospitalizations after cardiac arrest in the United States. METHODS AND RESULTS: We used the US Nationwide Inpatient Sample (2003-2012) to identify patients with cardiac arrest. Log transformation of inflation-adjusted cost was determined for care to patient outcomes. Overall, an estimated 1 387 396 patients were hospitalized after cardiac arrest. The mean age of the cohort was 66 years, 45% were women, and the majority were white. Inpatient procedures included coronary angiography (15%), percutaneous coronary intervention (7%), intra-aortic balloon pump (4.4%), therapeutic hypothermia (1.1%), and mechanical circulatory support (0.1%). The rates of therapeutic hypothermia increased from zero in 2003 to 2.7% in 2012 (P<0.001). Both hospital charges and inflation-adjusted cost increased linearly over time. In a multivariate analysis, predictors of inflation-adjusted cost included large hospital size, urban teaching hospital, and length of stay. Among comorbidities, atrial fibrillation or fluid and electrolytes imbalance was most associated with cost. Among selected interventions, the cost was significantly increased with automatic implantable cardioverter defibrillators (odds ratio, 1.83; P<0.001), intra-aortic balloon pump (odds ratio, 1.50; P<0.001), hypothermia (odds ratio, 1.28; P<0.001), and extracorporeal membrane oxygenation (odds ratio, 2.38; P<0.001). CONCLUSIONS: In the period between 2003 and 2012, postcardiac arrest hospitalizations resulted in a steady rise in associated health care cost, likely related to increased length of stay, medical procedures, and systems of care. Although targeted cost containment for postarrest interventions may reduce the finance burden, there is an increasing need for funding research into prediction and prevention of cardiac arrest, which offers greater societal benefit.
BACKGROUND: This study was designed to estimate the costs of index hospitalizations after cardiac arrest in the United States. METHODS AND RESULTS: We used the US Nationwide Inpatient Sample (2003-2012) to identify patients with cardiac arrest. Log transformation of inflation-adjusted cost was determined for care to patient outcomes. Overall, an estimated 1 387 396 patients were hospitalized after cardiac arrest. The mean age of the cohort was 66 years, 45% were women, and the majority were white. Inpatient procedures included coronary angiography (15%), percutaneous coronary intervention (7%), intra-aortic balloon pump (4.4%), therapeutic hypothermia (1.1%), and mechanical circulatory support (0.1%). The rates of therapeutic hypothermia increased from zero in 2003 to 2.7% in 2012 (P<0.001). Both hospital charges and inflation-adjusted cost increased linearly over time. In a multivariate analysis, predictors of inflation-adjusted cost included large hospital size, urban teaching hospital, and length of stay. Among comorbidities, atrial fibrillation or fluid and electrolytes imbalance was most associated with cost. Among selected interventions, the cost was significantly increased with automatic implantable cardioverter defibrillators (odds ratio, 1.83; P<0.001), intra-aortic balloon pump (odds ratio, 1.50; P<0.001), hypothermia (odds ratio, 1.28; P<0.001), and extracorporeal membrane oxygenation (odds ratio, 2.38; P<0.001). CONCLUSIONS: In the period between 2003 and 2012, postcardiac arrest hospitalizations resulted in a steady rise in associated health care cost, likely related to increased length of stay, medical procedures, and systems of care. Although targeted cost containment for postarrest interventions may reduce the finance burden, there is an increasing need for funding research into prediction and prevention of cardiac arrest, which offers greater societal benefit.
Authors: Edilberto Amorim; Shirley S Mo; Sebastian Palacios; Mohammad M Ghassemi; Wei-Hung Weng; Sydney S Cash; Matthew T Bianchi; M Brandon Westover Journal: Neurology Date: 2020-07-13 Impact factor: 9.910
Authors: Manuel Obermaier; Johannes B Zimmermann; Erik Popp; Markus A Weigand; Sebastian Weiterer; Alexander Dinse-Lambracht; Claus-Martin Muth; Benedikt L Nußbaum; Jan-Thorsten Gräsner; Stephan Seewald; Katrin Jensen; Svenja E Seide Journal: BMJ Open Date: 2021-02-15 Impact factor: 2.692
Authors: Ji Han Heo; Taegyun Kim; Jonghwan Shin; Gil Joon Suh; Joonghee Kim; Yoon Sun Jung; Seung Min Park; Sungwan Kim Journal: J Korean Med Sci Date: 2021-07-19 Impact factor: 2.153