Acute abdominal aortic aneurysms: cost analysis of endovascular repair and open surgery in hemodynamically stable patients with 1-year follow-up.
OBJECTIVE
To retrospectively assess the in-hospital and 1-year follow-up costs of endovascular aneurysm repair and conventional open surgery in patients with acute infrarenal abdominal aortic aneurysm (AAA) by using a resource-use approach.


METHODS
Institutional Review Board approval was obtained, and informed consent was waived. In-hospital costs for all consecutive patients (61 men, six women; mean age, 72.0 years) who underwent endovascular repair (n = 32) or open surgery (n = 35) for acute infrarenal AAA from January 1, 2001, to December 31, 2004, were assessed by using a resource-use approach. Patients who did not undergo computed tomography before the procedure were excluded from analysis. One-year follow-up costs were complete for 30 patients who underwent endovascular repair and for 34 patients who underwent open surgery. Costs were assessed from a health care perspective. Mean costs were calculated for each treatment group and were compared by using the Mann-Whitney U test (alpha = .05). The influence of clinical variables on the total in-hospital cost was investigated by using univariate and multivariate analyses. Costs were expressed in euros for the year 2003.


RESULTS
Sex, age, and comorbidity did not differ between treatment groups (P > .05). The mean total in-hospital costs were lower for patients who underwent endovascular repair than for those who underwent open surgery (euro20 767 vs euro35 470, respectively; P = .004). The total costs, including those for 1-year follow-up, were euro23 588 for patients who underwent endovascular repair and euro36 448 for those who underwent open surgery (P = .05). The results of multivariate analysis indicated that complications had a significant influence on total in-hospital cost; patients who had complications incurred total in-hospital costs that were 2.27 times higher than those for patients who had no complications.


CONCLUSIONS
Total in-hospital costs and total overall costs, which included 1-year follow-up costs, were lower in patients with acute AAA who underwent endovascular repair than in those who underwent open surgery.
Visser
Jacob J
JJ
Departments of Epidemiology and Biostatistics, Radiology, and Surgery, Erasmus Medical Center, Room Ee21-40B, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
van Sambeek
Marc R H M
MR
Hunink
M G Myriam
MG
Redekop
W Ken
WK
van Dijk
Lukas C
LC
Hendriks
Johanna M
JM
Bosch
Johanna L
JL
D000208:Acute Disease; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000191:economics* / Q000503:physiopathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D003365:Costs and Cost Analysis; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors