title: Comparative costs between myocardial revascularization with or without extracorporeal circulation.
abstract: BACKGROUND
  Surgical techniques of myocardial revascularization without the use of extracorporeal circulation (ECC) have raised hopes of attaining operative results with less systemic damage, lower occurrence of clinical complications and shorter hospital stay duration, generating expectations of lower hospital costs.
  
  
  OBJECTIVE
  To evaluate the hospital costs in patients submitted to myocardial revascularization with and without ECC and in those with stable multiarterial coronary disease with preserved ventricular function.
  
  
  METHODS
  The hospital costs were based on the existing governmental reimbursement. The costs included that of ortheses and prostheses and clinical complications. The time and costs of ICU stay and hospital stay duration were considered.
  
  
  RESULTS
  Between January 2002 and August 2006, 131 patients were randomized to surgery with ECC (SECC), whereas 128 were randomized to surgery without ECC (WECC). The basal characteristics were similar for both groups. The costs of surgical complications were significantly lower (p < 0.001) in patients from the WECC when compared to the SECC group (606.00 +/- 525.00 vs. 945.90 +/- 440.00), as well as ICU costs: 432.20 +/- 391.70 vs. 717.70 +/- 257.70, respectively. The duration of the operating room stay were 4.9 +/- 1.1 h vs. 3.9 +/- 1.0 h, p < 0.001; at the ICU it was 48.2 +/- 17.2 h vs. 29.2 +/- 26.1h) (p < 0.001), with intubation time of 9.2 +/- 4.5 h vs. 6.4 +/- 5.1h, p < 0.001 for patients from the group with and without ECC, respectively.
  
  
  CONCLUSIONS
  The present study allowed us to conclude that the myocardial revascularization surgery without extracorporeal circulation results in the decrease of operational costs and duration of the stay in each section related to the surgical treatment.
authors.affiliation: Instituto do Coração, Hospital do Coração, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brazil.
authors.forename: Priscyla B M A
authors.initials: PB
authors.lastname: Girardi
authors.forename: Whady
authors.initials: W
authors.lastname: Hueb
authors.forename: Célia R S R
authors.initials: CR
authors.lastname: Nogueira
authors.forename: Myrthes E
authors.initials: ME
authors.lastname: Takiuti
authors.forename: Teryo
authors.initials: T
authors.lastname: Nakano
authors.forename: Cibele Larrosa
authors.initials: CL
authors.lastname: Garzillo
authors.forename: Felipe da S
authors.initials: Fda S
authors.lastname: Paulitsch
authors.forename: Aécio F T
authors.initials: AF
authors.lastname: Góis
authors.forename: Neuza H M
authors.initials: NH
authors.lastname: Lopes
authors.forename: Noedir A
authors.initials: NA
authors.lastname: Stolf
mesh_terms: D005112:Extracorporeal Circulation / Q000191:economics*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000191:economics; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000191:economics* / Q000379:methods; D009873:Operating Rooms / Q000191:economics; D011183:Postoperative Complications / Q000191:economics; D018709:Statistics, Nonparametric; D013997:Time Factors