Costs of transradial percutaneous coronary intervention

Amit P. Amin, John A. House, David M. Safley, Adnan K. Chhatriwalla, Helmut Giersiefen, Andreas Bremer, Martial Hamon, Dmitri V. Baklanov, Akinyele Aluko, David Wohns, David W. Mathias, Robert A. Applegate, David J. Cohen, Steven P. Marso

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Objectives This study sought to evaluate the costs of transradial percutaneous coronary intervention (TRI) and transfemoral percutaneous coronary intervention (TFI) from a contemporary hospital perspective. Background Whereas the TRI approach to percutaneous coronary intervention (PCI) has been shown to reduce access-site complications compared with TFI, whether it is associated with lower costs is unknown. Methods TRI and TFI patients were identified at 5 U.S. centers. The primary outcome was the cost of percutaneous coronary intervention (PCI) hospitalization, defined as cost on the day of PCI through hospital discharge. Cost was obtained from each hospital's cost accounting system. Independent costs of TRI were identified using propensity-scoring methods with inverse probability weighting. Secondary outcomes of interest were bleeding, in-hospital mortality, and length of stay, which were stratified by pre-procedural risk and PCI indication. Results In 7,121 PCI procedures performed from January 1, 2010, to March 31, 2011, TRI was performed in 1,219 (17%) patients and was associated with shorter lengths of stay (2.5 vs. 3.0 days; p < 0.001) and lower bleeding events (1.1% vs. 2.4%, adjusted odds ratio [OR]: 0.52, 95% confidence interval [CI]: 0.34 to 0.79; p = 0.002). TRI was associated with a total cost savings of $830 (95% CI: $296 to $1,364; p < 0.001), of which $130 (95% CI: -$99 to $361; p = 0.112) were procedural savings and $705 (95% CI: $212 to $1,238; p < 0.001) were post-procedural savings. There was an associated graded increase in savings among patients at higher predicted risk of bleeding: low risk: $642 (95% CI: $43 to $1,236; p = 0.035); moderate risk: $706 (95% CI: $104 to $1,308; p = 0.029); and high risk: $1,621 (95% CI: $271 to $2,971, p = 0.039). Conclusions TRI was associated with a cost savings exceeding $800 per patient relative to TFI. Increased adoption of TRI may result in cost savings at hospitals.

Original languageEnglish (US)
Pages (from-to)827-834
Number of pages8
JournalJACC: Cardiovascular Interventions
Volume6
Issue number8
DOIs
StatePublished - Aug 2013

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Percutaneous Coronary Intervention
Confidence Intervals
Costs and Cost Analysis
Cost Savings
Hemorrhage
Length of Stay
Hospital Costs
Hospital Mortality
Hospitalization
Research Design
Odds Ratio

Keywords

  • catheterization costs femoral artery outcomes percutaneous coronary intervention radial artery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Amin, A. P., House, J. A., Safley, D. M., Chhatriwalla, A. K., Giersiefen, H., Bremer, A., ... Marso, S. P. (2013). Costs of transradial percutaneous coronary intervention. JACC: Cardiovascular Interventions, 6(8), 827-834. https://doi.org/10.1016/j.jcin.2013.04.014

Costs of transradial percutaneous coronary intervention. / Amin, Amit P.; House, John A.; Safley, David M.; Chhatriwalla, Adnan K.; Giersiefen, Helmut; Bremer, Andreas; Hamon, Martial; Baklanov, Dmitri V.; Aluko, Akinyele; Wohns, David; Mathias, David W.; Applegate, Robert A.; Cohen, David J.; Marso, Steven P.

In: JACC: Cardiovascular Interventions, Vol. 6, No. 8, 08.2013, p. 827-834.

Research output: Contribution to journalArticle

Amin, AP, House, JA, Safley, DM, Chhatriwalla, AK, Giersiefen, H, Bremer, A, Hamon, M, Baklanov, DV, Aluko, A, Wohns, D, Mathias, DW, Applegate, RA, Cohen, DJ & Marso, SP 2013, 'Costs of transradial percutaneous coronary intervention', JACC: Cardiovascular Interventions, vol. 6, no. 8, pp. 827-834. https://doi.org/10.1016/j.jcin.2013.04.014
Amin AP, House JA, Safley DM, Chhatriwalla AK, Giersiefen H, Bremer A et al. Costs of transradial percutaneous coronary intervention. JACC: Cardiovascular Interventions. 2013 Aug;6(8):827-834. https://doi.org/10.1016/j.jcin.2013.04.014
Amin, Amit P. ; House, John A. ; Safley, David M. ; Chhatriwalla, Adnan K. ; Giersiefen, Helmut ; Bremer, Andreas ; Hamon, Martial ; Baklanov, Dmitri V. ; Aluko, Akinyele ; Wohns, David ; Mathias, David W. ; Applegate, Robert A. ; Cohen, David J. ; Marso, Steven P. / Costs of transradial percutaneous coronary intervention. In: JACC: Cardiovascular Interventions. 2013 ; Vol. 6, No. 8. pp. 827-834.
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abstract = "Objectives This study sought to evaluate the costs of transradial percutaneous coronary intervention (TRI) and transfemoral percutaneous coronary intervention (TFI) from a contemporary hospital perspective. Background Whereas the TRI approach to percutaneous coronary intervention (PCI) has been shown to reduce access-site complications compared with TFI, whether it is associated with lower costs is unknown. Methods TRI and TFI patients were identified at 5 U.S. centers. The primary outcome was the cost of percutaneous coronary intervention (PCI) hospitalization, defined as cost on the day of PCI through hospital discharge. Cost was obtained from each hospital's cost accounting system. Independent costs of TRI were identified using propensity-scoring methods with inverse probability weighting. Secondary outcomes of interest were bleeding, in-hospital mortality, and length of stay, which were stratified by pre-procedural risk and PCI indication. Results In 7,121 PCI procedures performed from January 1, 2010, to March 31, 2011, TRI was performed in 1,219 (17{\%}) patients and was associated with shorter lengths of stay (2.5 vs. 3.0 days; p < 0.001) and lower bleeding events (1.1{\%} vs. 2.4{\%}, adjusted odds ratio [OR]: 0.52, 95{\%} confidence interval [CI]: 0.34 to 0.79; p = 0.002). TRI was associated with a total cost savings of $830 (95{\%} CI: $296 to $1,364; p < 0.001), of which $130 (95{\%} CI: -$99 to $361; p = 0.112) were procedural savings and $705 (95{\%} CI: $212 to $1,238; p < 0.001) were post-procedural savings. There was an associated graded increase in savings among patients at higher predicted risk of bleeding: low risk: $642 (95{\%} CI: $43 to $1,236; p = 0.035); moderate risk: $706 (95{\%} CI: $104 to $1,308; p = 0.029); and high risk: $1,621 (95{\%} CI: $271 to $2,971, p = 0.039). Conclusions TRI was associated with a cost savings exceeding $800 per patient relative to TFI. Increased adoption of TRI may result in cost savings at hospitals.",
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T1 - Costs of transradial percutaneous coronary intervention

AU - Amin, Amit P.

AU - House, John A.

AU - Safley, David M.

AU - Chhatriwalla, Adnan K.

AU - Giersiefen, Helmut

AU - Bremer, Andreas

AU - Hamon, Martial

AU - Baklanov, Dmitri V.

AU - Aluko, Akinyele

AU - Wohns, David

AU - Mathias, David W.

AU - Applegate, Robert A.

AU - Cohen, David J.

AU - Marso, Steven P.

PY - 2013/8

Y1 - 2013/8

N2 - Objectives This study sought to evaluate the costs of transradial percutaneous coronary intervention (TRI) and transfemoral percutaneous coronary intervention (TFI) from a contemporary hospital perspective. Background Whereas the TRI approach to percutaneous coronary intervention (PCI) has been shown to reduce access-site complications compared with TFI, whether it is associated with lower costs is unknown. Methods TRI and TFI patients were identified at 5 U.S. centers. The primary outcome was the cost of percutaneous coronary intervention (PCI) hospitalization, defined as cost on the day of PCI through hospital discharge. Cost was obtained from each hospital's cost accounting system. Independent costs of TRI were identified using propensity-scoring methods with inverse probability weighting. Secondary outcomes of interest were bleeding, in-hospital mortality, and length of stay, which were stratified by pre-procedural risk and PCI indication. Results In 7,121 PCI procedures performed from January 1, 2010, to March 31, 2011, TRI was performed in 1,219 (17%) patients and was associated with shorter lengths of stay (2.5 vs. 3.0 days; p < 0.001) and lower bleeding events (1.1% vs. 2.4%, adjusted odds ratio [OR]: 0.52, 95% confidence interval [CI]: 0.34 to 0.79; p = 0.002). TRI was associated with a total cost savings of $830 (95% CI: $296 to $1,364; p < 0.001), of which $130 (95% CI: -$99 to $361; p = 0.112) were procedural savings and $705 (95% CI: $212 to $1,238; p < 0.001) were post-procedural savings. There was an associated graded increase in savings among patients at higher predicted risk of bleeding: low risk: $642 (95% CI: $43 to $1,236; p = 0.035); moderate risk: $706 (95% CI: $104 to $1,308; p = 0.029); and high risk: $1,621 (95% CI: $271 to $2,971, p = 0.039). Conclusions TRI was associated with a cost savings exceeding $800 per patient relative to TFI. Increased adoption of TRI may result in cost savings at hospitals.

AB - Objectives This study sought to evaluate the costs of transradial percutaneous coronary intervention (TRI) and transfemoral percutaneous coronary intervention (TFI) from a contemporary hospital perspective. Background Whereas the TRI approach to percutaneous coronary intervention (PCI) has been shown to reduce access-site complications compared with TFI, whether it is associated with lower costs is unknown. Methods TRI and TFI patients were identified at 5 U.S. centers. The primary outcome was the cost of percutaneous coronary intervention (PCI) hospitalization, defined as cost on the day of PCI through hospital discharge. Cost was obtained from each hospital's cost accounting system. Independent costs of TRI were identified using propensity-scoring methods with inverse probability weighting. Secondary outcomes of interest were bleeding, in-hospital mortality, and length of stay, which were stratified by pre-procedural risk and PCI indication. Results In 7,121 PCI procedures performed from January 1, 2010, to March 31, 2011, TRI was performed in 1,219 (17%) patients and was associated with shorter lengths of stay (2.5 vs. 3.0 days; p < 0.001) and lower bleeding events (1.1% vs. 2.4%, adjusted odds ratio [OR]: 0.52, 95% confidence interval [CI]: 0.34 to 0.79; p = 0.002). TRI was associated with a total cost savings of $830 (95% CI: $296 to $1,364; p < 0.001), of which $130 (95% CI: -$99 to $361; p = 0.112) were procedural savings and $705 (95% CI: $212 to $1,238; p < 0.001) were post-procedural savings. There was an associated graded increase in savings among patients at higher predicted risk of bleeding: low risk: $642 (95% CI: $43 to $1,236; p = 0.035); moderate risk: $706 (95% CI: $104 to $1,308; p = 0.029); and high risk: $1,621 (95% CI: $271 to $2,971, p = 0.039). Conclusions TRI was associated with a cost savings exceeding $800 per patient relative to TFI. Increased adoption of TRI may result in cost savings at hospitals.

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