title: Myocardial infarction following coronary artery bypass graft surgery increases healthcare resource utilization.
abstract: OBJECTIVE
  To assess the health economic impact of perioperative myocardial infarction in a cohort of patients undergoing coronary artery bypass graft surgery.
  
  
  METHODS
  Retrospective cohort analysis using data from hospital bills and uniform billing forms.
  
  
  METHODS
  A total of 147 geographically diverse hospitals in the United States.
  
  
  METHODS
  The study population consisted of 2,102 coronary artery bypass graft surgery patients enrolled in the PRIMO-CABG trial at U.S. sites between January 2002 and February 2003.
  
  
  METHODS
  None.
  
  
  RESULTS
  Resource utilization and costs during the index hospitalization and during a 6-month follow-up period were compared between patients who had a myocardial infarction by postoperative day 4 and those who did not. Linear regression was used to examine whether myocardial infarction by day 4 was associated with index hospitalization costs, after adjusting for baseline characteristics. Myocardial infarction occurred in 191 (9.1%) patients undergoing coronary artery bypass graft surgery. Myocardial infarction was associated with a doubling of intensive care unit time (3.5 days among patients with no myocardial infarction and 7.1 days among patients with myocardial infarction, p < .01) and a 48% increase in hospital length of stay. Myocardial infarction by day 4 was associated with a 43% increase in hospital costs, a 29% increase in physician service costs, a 41% increase in total costs during the index hospitalization, and a 38% increase in cumulative 6-month costs. After baseline adjustment, myocardial infarction continued to be associated with higher index hospitalization costs.
  
  
  CONCLUSIONS
  Myocardial infarction following coronary artery bypass graft surgery was associated with a significant increase in intensive care unit time, hospital length of stay, and overall costs, which contributed to greater hospital and physician service costs. Healthcare resource utilization is increased in patients sustaining a myocardial infarction following coronary artery bypass graft surgery.
authors.affiliation: Division of Cardiothoracic Surgery, University of Hawaii School of Medicine, Honolulu, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Chen
authors.forename: Padma
authors.initials: P
authors.lastname: Kaul
authors.forename: Jerrold H
authors.initials: JH
authors.lastname: Levy
authors.forename: Axel
authors.initials: A
authors.lastname: Haverich
authors.forename: Philippe
authors.initials: P
authors.lastname: Menasché
authors.forename: Peter K
authors.initials: PK
authors.lastname: Smith
authors.forename: Michel
authors.initials: M
authors.lastname: Carrier
authors.forename: Edward D
authors.initials: ED
authors.lastname: Verrier
authors.forename: Frans
authors.initials: F
authors.lastname: Van de Werf
authors.forename: Russel
authors.initials: R
authors.lastname: Burge
authors.forename: Paul
authors.initials: P
authors.lastname: Finnegan
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Mark
authors.forename: Stanton K
authors.initials: SK
authors.lastname: Shernan
mesh_terms: D000368:Aged; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000191:economics*; D005260:Female; D005500:Follow-Up Studies; D006295:Health Resources / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000191:economics* / Q000209:etiology; D012189:Retrospective Studies; D014481:United States