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  1. Cost reduction by combined carotid endarterectomy and coronary artery bypass grafting. Discussion.

    Article, Communication - En anglais

    Annual Meeting of The Western Thoracic Surgical Association. Coeur d'Alene, Idaho USA, 1995/06/21.

    A significant cost reduction is likely if patients who require coronary artery bypass grafting with significant carotid stenosis have simultaneous carotid endarterectomy and bypass grafting, provided risk is not increased.

    To investigate this issue, we retrospectively identified cases from February 1977 to May 1994 with first-time isolated carotid endarterectomy, coronary bypass, or combined procedures.

    In the isolated carotid endarterectomy population, median age was 69 years and 58% (85/146) were male, as compared with 68 years and 68% (68/100) male in the combined group ; median age of the coronary bypass cohort was 65 years and 76% (381/500) male.

    A significantly higher percentage of patients in the coronary bypass versus combined group were in New York Heart Association functional class IV.

    In the combined group there was a significantly higher incidence of older age, diabetes, hypertension, hyperlipidemia, renal failure, and congestive heart failure.

    There was no difference among the three groups with respect to hospital mortality (0%, 3.4%, and 4.0%, respectively) and permanent stroke (0.7%, 1.2%, and 0%, respectively).

    Hospital costs were $4,896, $10,959 and $11,089, respectively, with a savings of $4,766 (30%), and Medicare hospital reimbursement was $8,575, $23,071, and $23,071, respectively, with a savings of $10,077 (25.3%). (...)

    Mots-clés Pascal : Athérosclérose, Cardiopathie coronaire, Sténose, Carotide, Endartériectomie, Dérivation, Aortocoronaire, Analyse avantage coût, Evaluation, Economie santé, Traitement, Technique, Homme, Système nerveux pathologie, Encéphale pathologie, Cérébrovasculaire pathologie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Artère pathologie, Système nerveux central pathologie, Chirurgie

    Mots-clés Pascal anglais : Atherosclerosis, Coronary heart disease, Stenosis, Carotid, Endarteriectomy, Bypass, Aortocoronary, Cost benefit analysis, Evaluation, Health economy, Treatment, Technique, Human, Nervous system diseases, Cerebral disorder, Cerebrovascular disease, Cardiovascular disease, Vascular disease, Arterial disease, Central nervous system disease, Surgery

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0305285

    Code Inist : 002B25E. Création : 10/04/1997.