Universität zu Köln

Iliadis, Christos ORCID: 0000-0001-7655-8500, Schwabe, Leandra, Mueller, Dirk, Stock, Stephanie, Baldus, Stephan and Pfister, Roman . Impact of frailty on periprocedural health care utilization in patients undergoing transcatheter edge-to-edge mitral valve repair. Clin. Res. Cardiol.. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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Abstract

Background Frailty is a common characteristic of patients undergoing transcatheter mitral valve repair (TMVR). It is unclear whether the physical vulnerability of frail patients translates into increased procedural health care utilization. Methods and results Frailty was assessed using the Fried criteria in 229 patients undergoing TMVR using the MitraClip system at our institution and associations with total costs and costs by cost centers within the hospital incurred during periprocedural hospitalization were examined. Frail patients (n = 107, 47%) compared to non-frail patients showed significantly higher total costs [median/interquartile range, excluding implant costs: 7,337 euro (5,911-9,814) vs 6,238 euro (5,584-7,499), p = 0.001], with a difference in means of 2,317 euro. Frailty was the only clinical baseline characteristic with significant association with total costs. Higher total costs in frail patients were attributable primarily to longer stay on intermediate/intensive care unit (3.8 +/- 5.7 days in frail vs 2.1 +/- 1.7 days in non-frail, p = 0.003), but also to costs of clinical chemistry and physiotherapy. The prolonged stay on intermediate/intensive care unit in frail patients was attributable to postprocedural complications such as bleeding, kidney injury, infections and cardiovascular instability. Conclusion Frailty is associated with a mean 32% increase of hospital costs in patients undergoing TMVR, which is primarily the result of a prolonged recovery and increased vulnerability to complications. These findings are valuable for a hospital's total cost calculation and resource allocation planning. Since frailty is regarded a potentially reversible health state, preventive interventions may help reduce costs in frail patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Iliadis, Christos UNSPECIFIED orcid.org/0000-0001-7655-8500 UNSPECIFIED Schwabe, Leandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Dirk UNSPECIFIED UNSPECIFIED UNSPECIFIED Stock, Stephanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-307843
DOI:	10.1007/s00392-020-01789-5
Journal or Publication Title:	Clin. Res. Cardiol.
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OLDER-ADULTS; INSTRUMENTAL ACTIVITIES; REPLACEMENT; OUTCOMES; SURGERY; DISEASE; COST; RISK Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/30784