Cardiothoracic and Vascular Anesthesia

Cost and cost-effectiveness of cardiac surgery in elderly patients

Gelsomino S, Lorusso R, Livi U, et al (Careggi Hosp, Florence, Italy; Civic Hosp, Brescia, Italy; General Hosp S. Maria della Misericordia, Udine, Italy; et al) J Thorac Cardiovasc Surg 142:1062-1073, 2011^§

Abstract

Objective

Cost-effectiveness of heart surgery for elderly patients is still poorly defined. We evaluated outcome, quality of life (QoL), cost, and cost-effectiveness of octogenarians undergoing cardiac surgery.

Methods

One thousand six hundred forty octogenarians undergoing various cardiac surgical procedures were prospectively studied between January 1998 and January 2009 and compared with similar patients aged 70 to 79 years. Several questionnaires were used to assess QoL. Six hundred age- and sex- matched healthy octogenarians and three hundred forty patients older than 80 years with medically treated valvular or coronary artery disease were healthy and unoperated control groups, respectively. In-hospital costs were obtained from the hospital’s financial accounting department and cost-effectiveness was estimated and expressed as cost/QoL-adjusted life year (QALY) and cost-effectiveness ratio.

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