Mechanical circulatory support costs in children bridged to heart transplantation - analysis of a linked database

American Heart Journal
Justin GodownBrian Feingold

Abstract

Pediatric mechanical circulatory support (MCS) has evolved considerably over the past decade. Though marked improvements in waitlist survival have been realized, costs have not been reassessed. This project aimed to assess contemporary MCS costs in children bridged to heart transplant (HT). All pediatric HT recipients (2002-2016) were identified from a unique, linked PHIS/SRTR dataset. Costs were calculated from hospital charges, inflated to 2016 Dollars and adjusted for patient-specific characteristics using generalized linear mixed-effects models. Costs and length of stay (LOS) were compared across support strategies at the time of HT (no MCS, VAD, or ECMO) with select subgroup analyses. A total of 2873 pediatric HT recipients were included; no MCS: 2268 (78.9%), VAD: 470 (16.4%), and ECMO: 135 (4.7%). Both VAD and ECMO were associated with greater total hospitalization costs compared to no MCS ($755,345 and $808,771 vs. $457,086; P < .001). Total costs and LOS were similar between VAD and ECMO groups; however, costs and LOS were greatest for VAD-supported patients in the pre-HT period and greatest for ECMO-supported patients post-HT. Post-HT costs and LOS were similar between patients who did not require MCS and those suppor...Continue Reading

References

Dec 4, 2001·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·W E Richenbacher, S C Seemuth
Apr 15, 2004·Statistics in Medicine·R M Nixon, S G Thompson
Feb 11, 2005·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Paul L DigiorgiMehmet C Oz
May 4, 2005·The Journal of Thoracic and Cardiovascular Surgery·William T MahleKirk R Kanter
Feb 27, 2007·The Journal of Thoracic and Cardiovascular Surgery·Allison R SchulmanYoshifumi Naka
Dec 4, 2008·The Annals of Thoracic Surgery·William T MahleKirk R Kanter
Jan 13, 2009·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Kate L BrownJohn Cairns
Aug 28, 2010·Health Economics·Borislava MihaylovaSimon G Thompson
Sep 3, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·T P SinghK Gauvreau
Sep 18, 2012·Journal of Cardiac Surgery·Nance YuanJohn V Conte
Dec 19, 2012·The Journal of Thoracic and Cardiovascular Surgery·Daniel P MulloyJohn A Kern
Jan 29, 2014·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Seth A HollanderDavid N Rosenthal
Aug 29, 2014·Pediatric Transplantation·Justin GodownKurt R Schumacher
Dec 3, 2014·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Farhan ZafarDavid L S Morales
Jul 25, 2015·Circulation. Heart Failure·Anne I DipchandUNKNOWN Pediatric Heart Transplant Study Investigators
Jan 1, 2016·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Sharon ChenDavid N Rosenthal
Feb 26, 2016·Clinical Transplantation·Silvana F MarascoMarco Luthe
May 21, 2016·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·David N RosenthalElizabeth D Blume
Aug 11, 2016·Pediatric Transplantation·Justin GodownDebra A Dodd
Dec 24, 2016·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Seth A HollanderDavid N Rosenthal
Jan 27, 2017·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Chet R VillaAngela Lorts

❮ Previous
Next ❯

Citations

Jan 24, 2019·The Journal of Thoracic and Cardiovascular Surgery·Son Q DuongBrian Feingold
Mar 22, 2021·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Danielle S BursteinJoseph W Rossano
Nov 17, 2020·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·David W BearlJustin Godown

❮ Previous
Next ❯

Related Concepts

Related Feeds

Artificial Heart & Ventricular Assist Devices

Total artificial hearts (TAH) and ventricular assist devices (VADs) provide cardiac support for patients with end-stage heart disease and have significantly improved the survival of these patients. Discover the latest research on Artificial Heart and Ventricular Assist Devices here.