CORRELATES OF IN-HOSPITAL COST AMONG PATIENTS UNDERGOING ABDOMINAL AORTIC-ANEURYSM REPAIR

Background surgical repair of abdominal aortic aneurysms (AAA) is incr easingly being performed, but little is known about the correlates of in-hospital cost associated with this procedure. Methods and Results B aseline clinical characteristics, in-hospital outcomes, and total in-h ospital costs were examined among a retrospective cohort of 71 patient s who underwent AAA repair. Median age was 68 years, and 75% of the pa tients were men. High-risk characteristics for perioperative complicat ions were common and included hypertension (73%), documented coronary artery disease (66%), smoking (60%), previous myocardial infarction (4 7%), history of congestive heart failure (12%), urgent or emergent AAA repair (16%), and diabetes mellitus (11%). Perioperative complication s included congestive heart failure (13%), myocardial infarction (11%) , and death (1%). Median length of stay in the surgical intensive care unit (SICU) was 2 days (range 0 to 28), and median in-hospital stay w as 9 days (range 5 to 39). In-hospital cost For the 71 patients ranged from $13,766 to $82,435 (mean $25,931, median $21,633). Univariate an d multiple linear regression analyses demonstrated that among the pote ntial correlates investigated, number of SICU days (P = .007) and tota l length of stay (P < .0001) were the most closely associated with in- hospital cost. Conclusions Among patients undergoing AAA repair, the m ajor correlates of in-hospital cost are the number of days spent in th e SICU and the total number of days spent in the hospital. These resul ts suggest that any intervention that reduces length of stay may signi ficantly reduce the total in-hospital cost associated with AAA repair.