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Cost comparison of transcatheter and operative closures of ostium secundum atrial septal defects

Overview of attention for article published in American Heart Journal, February 2015
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Title
Cost comparison of transcatheter and operative closures of ostium secundum atrial septal defects
Published in
American Heart Journal, February 2015
DOI 10.1016/j.ahj.2015.02.010
Pubmed ID
Authors

Michael L. O’Byrne, Matthew J. Gillespie, Russell T. Shinohara, Yoav Dori, Jonathan J. Rome, Andrew C. Glatz

Abstract

Clinical outcomes for transcatheter and operative closures of atrial septal defects (ASDs) are similar. Economic cost for each method has not been well described. A single-center retrospective cohort study of children and adults<30 years of age undergoing closure for single secundum ASD from January 1, 2007, to April 1, 2012, was performed to measure differences in inflation-adjusted cost of operative and transcatheter closures of ASD. A propensity score weight-adjusted multivariate regression model was used in an intention-to-treat analysis. Costs for reintervention and crossover admissions were included in primary analysis. A total of 244 subjects were included in the study (64% transcatheter and 36% operative), of which 2% (n = 5) were ≥18 years. Crossover rate from transcatheter to operative group was 3%. Risk of reintervention (P = .66) and 30-day mortality (P = .37) were not significantly different. In a multivariate model, adjusted cost of operative closure was 2012 US $60,992 versus 2012 US $55,841 for transcatheter closure (P < .001). Components of total cost favoring transcatheter closure were length of stay, medications, and follow-up radiologic and laboratory testing, overcoming higher costs of procedure and echocardiography. Professional costs did not differ. The rate of 30-day readmission was greater in the operative cohort, further increasing the cost advantage of transcatheter closure. Sensitivity analyses demonstrated that costs of follow-up visits influenced relative cost but that device closure remained favorable over a broad range of crossover and reintervention rates. For single secundum ASD, cost comparison analysis favors transcatheter closure over the short term. The cost of follow-up regimens influences the cost advantage of transcatheter closure.

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Mendeley readers

The data shown below were compiled from readership statistics for 47 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Belgium 1 2%
Unknown 46 98%

Demographic breakdown

Readers by professional status Count As %
Researcher 6 13%
Student > Bachelor 6 13%
Student > Master 5 11%
Student > Doctoral Student 4 9%
Student > Ph. D. Student 3 6%
Other 8 17%
Unknown 15 32%
Readers by discipline Count As %
Medicine and Dentistry 20 43%
Nursing and Health Professions 4 9%
Agricultural and Biological Sciences 2 4%
Economics, Econometrics and Finance 2 4%
Psychology 2 4%
Other 4 9%
Unknown 13 28%