Inpatient costs of routine endovascular repair of abdominal aortic aneurysm

Rationale and Objectives. The purpose of this study was to determine the in patient cost of routine (ie, without emergent conversion to open repair dur ing the hospital stay) endovascular stent-graft placement in a consecutive series of patients undergoing elective endovascular repair of abdominal aor tic aneurysm (AAA) at a single institution. Materials and Methods. Inpatient hospital costs of 91 patients who underwen t initial elective endovascular repair of AAA were analyzed retrospectively . All patients had participated in clinical trials at the authors' institut ion during the previous 6 years. Financial data were derived from the hospi tal's cost-accounting system; additional procedural data were collected fro m a departmental database and with chart review. Stent-graft and profession al costs were excluded. Results. The mean total cost for endovascular repair was $11,842 (standard deviation [SD], $5,127), mean procedure time was 149 minutes (SD, 79 minute s), and mean length of stay was 3.5 days (SD, 2.3 days). Total cost depende d on stent-graft type (means, $12,428 [bifurcated] vs $9,622 [tube]; P = .0 002) and strongly correlated with procedure time and length of hospital sta y (r = 0.78 and 0.66, respectively; P < .0001). Ninety-six percent of total costs for all patients were attributable to the following departments: ope rating theater (31%), radiology (31%), nursing (22%), and anesthesia (12%). Conclusion. Overall costs are greater with bifurcated than with tube stent- grafts. Total procedure-related costs are divided relatively equally betwee n the operating theater, the radiology department, and the combination of t he nursing and anesthesia departments.