title: The costs of surgery for limb-threatening ischemia.
abstract: The clinical courses of 106 patients with limb-threatening ischemia were traced for as long as 5 years to determine the cost of their care. Seventy-eight patients initially treated with vascular reconstruction accrued an average of $40,769 +/- $3726 in costs over a mean follow-up period of 805 +/- 57 days, during which they had an average of 2.4 +/- 0.2 hospitalizations or 67 +/- 6 inpatient days. Twenty-eight high-risk patients treated with primary amputation accrued $40,563 +/- $4729 in costs over a mean follow-up period of 663 +/- 97 days, during which they had an average of 2.2 +/- 0.3 hospitalizations or 85 +/- 10 inpatient days. Successful revascularization resulted in lower costs ($28,374) than did primary amputation ($40,563) or failed reconstruction ($56,809). Patients with ischemic tissue loss accrued costs more rapidly than did patients with rest pain only. The high cost of providing care for these patients and the advent of diagnosis related group reimbursement mandate that proposed treatment protocols be evaluated not only for their effectiveness but also for their cost-effectiveness.
authors.forename: W C
authors.initials: WC
authors.lastname: Mackey
authors.forename: J L
authors.initials: JL
authors.lastname: McCullough
authors.forename: T P
authors.initials: TP
authors.lastname: Conlon
authors.forename: A D
authors.initials: AD
authors.lastname: Shepard
authors.forename: R A
authors.initials: RA
authors.lastname: Deterling
authors.forename: A D
authors.initials: AD
authors.lastname: Callow
authors.forename: T F
authors.initials: TF
authors.lastname: O'Donnell
mesh_terms: D000206:Actuarial Analysis; D000368:Aged; D000671:Amputation, Surgical / Q000191:economics; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000191:economics*