title: Intrabronchial Valve Treatment for Prolonged Air Leak: Can We Justify the Cost?
abstract: Background. Prolonged air leak is defined as an ongoing air leak for more than 5 days. Intrabronchial valve (IBV) treatment is approved for the treatment of air leaks. Objective. To analyze our experience with IBV and valuate its cost-effectiveness. Methods. Retrospective analysis of IBV from June 2013 to October 2014. We analyzed direct costs based on hospital and operating room charges. We used average costs in US dollars for the analysis not individual patient data. Results. We treated 13 patients (9 M/4 F), median age of 60 years (38 to 90). Median time from diagnosis to IBV placement was 9.8 days, time from IBV placement to chest tube removal was 3 days, and time from IBV placement to hospital discharge was 4 days. Average room and board costs were $14,605 including all levels of care. IBV cost is $2750 per valve. The average number of valves used was 4. Total cost of procedure, valves, and hospital stay until discharge was $13,900. Conclusion. In our limited experience, the use of IBV to treat prolonged air leaks is safe and appears cost-effective. In pure financial terms, the cost seems justified for any air leak predicted to last greater than 8 days.
authors.affiliation: Division of Cardiothoracic Surgery, Section of Thoracic and Foregut Surgery, University of Minnesota, MMC 207, 420 Delaware Street, SE, Minneapolis, MN 55455, USA.
authors.forename: Eitan
authors.initials: E
authors.lastname: Podgaetz
authors.affiliation: Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Minnesota, MMC No. 276, 420 Delaware Street, SE, Minneapolis, MN 55455, USA.
authors.forename: Felix
authors.initials: F
authors.lastname: Zamora
authors.affiliation: Cardiopulmonary Services, Endoscopy Department, University of Minnesota, MMC No. 247, 500 Harvard Street, SE, Minneapolis, MN 55455, USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Gibson
authors.affiliation: Division of Cardiothoracic Surgery, Section of Thoracic and Foregut Surgery, University of Minnesota, MMC 207, 420 Delaware Street, SE, Minneapolis, MN 55455, USA.
authors.forename: Rafael S
authors.initials: RS
authors.lastname: Andrade
authors.affiliation: University of Minnesota, Financial Office, 500 Harvard Street, SE, Minneapolis, MN 55455, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Hall
authors.affiliation: Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Minnesota, MMC No. 276, 420 Delaware Street, SE, Minneapolis, MN 55455, USA.
authors.forename: H Erhan
authors.initials: HE
authors.lastname: Dincer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy / Q000191:economics* / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016156:Respiratory Tract Fistula / Q000628:therapy*; D012189:Retrospective Studies