Percutaneous cardiac assist devices compared with surgical hemodynamic support alternatives: cost-effectiveness in the emergent setting

This study evaluates the cost-effectiveness of percutaneous cardiac assist device (pVAD) therapy in the emergent setting compared with traditional surgical hemodynamic support alternatives. Previous research has demonstrated the cost-effectiveness of pVAD hemodynamic support for patients undergoing...

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Bibliographic Details
Published in:Catheterization and cardiovascular interventions 2014-05, Vol.83 (6), p.E183-E192
Main Authors: Maini, Brijeshwar, Gregory, David, Scotti, Dennis J, Buyantseva, Larisa
Format: Article
Language:English
Subjects:
Cardiac Catheterization - adverse effects
Cardiac Catheterization - economics
Cardiac Catheterization - instrumentation
Cardiac Catheterization - mortality
Cardiology Service, Hospital - economics
Cost-Benefit Analysis
Emergency Service, Hospital - economics
Heart-Assist Devices - economics
Hemodynamics
Hospital Costs
Humans
Length of Stay - economics
Models, Economic
Myocardial Infarction - complications
Myocardial Infarction - diagnosis
Myocardial Infarction - economics
Myocardial Infarction - mortality
Myocardial Infarction - physiopathology
Myocardial Infarction - therapy
Patient Discharge - economics
Pennsylvania
Prosthesis Design
Prosthesis Implantation - adverse effects
Prosthesis Implantation - economics
Prosthesis Implantation - instrumentation
Prosthesis Implantation - methods
Prosthesis Implantation - mortality
Quality-Adjusted Life Years
Retrospective Studies
Shock, Cardiogenic - diagnosis
Shock, Cardiogenic - economics
Shock, Cardiogenic - etiology
Shock, Cardiogenic - mortality
Shock, Cardiogenic - physiopathology
Shock, Cardiogenic - therapy
Time Factors
Treatment Outcome
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Description
Summary:This study evaluates the cost-effectiveness of percutaneous cardiac assist device (pVAD) therapy in the emergent setting compared with traditional surgical hemodynamic support alternatives. Previous research has demonstrated the cost-effectiveness of pVAD hemodynamic support for patients undergoing high-risk percutaneous coronary intervention. For patients in cardiogenic shock (CS), use of pVAD therapy has been shown to reduce length of stay (LOS). National utilization and outcome data from the 2010-2011 MedPAR and state-sponsored all-payer databases were collected for patients with an acute myocardial infarction complicated by CS who were treated with either a pVAD (n = 883) or with traditional surgical hemodynamic support alternatives (ECMO and extracorporeal VAD) (n = 305). Discharge survival was greater with pVADs than with surgical alternatives (56% vs. 42%, P 
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.25247