Abstract：
OBJECTIVE: During life-threatening emergencies or risky cardiologic interventions, pharmacology can be limited and the use of appropriate medical devices is then necessary. The Impella™ catheter, CP and 2.5, has been referenced for the exclusive use of the interventional cardiology technical platform at Hôpital Nord (AP-HM) in the absence of rapid access to the Extracorporeal Circulation unit. It is a temporary mechanical circulatory support device mainly indicated in refractory cardiogenic shock and coronary angioplasty at high risk of hemodynamic instability. The objective of this study, observational and retrospective, is to carry out a clinical and economic assessment linked to the use of this device over a period of four years (2017-2020).
METHODS: The criteria relating to the 71 patients (51 Impella™ CP and 20 Impella™ 2.5) and their clinical evolution as well as the costs and valuation of the stays were determined.
RESULTS: In particular, the Impella™ CP enabled myocardial recovery in 18 out of 51 patients and it was an intermediary in the context of heavier care for 11 patients. The balance between expenditure and valuation shows a deficit of -819,937 euros over the study period, with however a probable margin for improvement.
CONCLUSIONS: The Impella™ is of clinical interest under very specific conditions. Its high cost and the absence of inclusion on the list of reimbursements in addition to Homogeneous Groups of Stays represent a significant financial burden for health care establishments. Thus, optimizing the rating of future stays is a necessity.
METHODS: The criteria relating to the 71 patients (51 Impella™ CP and 20 Impella™ 2.5) and their clinical evolution as well as the costs and valuation of the stays were determined.
RESULTS: In particular, the Impella™ CP enabled myocardial recovery in 18 out of 51 patients and it was an intermediary in the context of heavier care for 11 patients. The balance between expenditure and valuation shows a deficit of -819,937 euros over the study period, with however a probable margin for improvement.
CONCLUSIONS: The Impella™ is of clinical interest under very specific conditions. Its high cost and the absence of inclusion on the list of reimbursements in addition to Homogeneous Groups of Stays represent a significant financial burden for health care establishments. Thus, optimizing the rating of future stays is a necessity.
摘要：
目标：在危及生命的紧急情况或危险的心脏干预期间，药理学可能会受到限制，因此需要使用适当的医疗设备。Impella™导管,CP和2.5已被引用为在无法快速进入体外循环单元的情况下，在HópitalNord（AP-HM）的介入心脏病学技术平台的独家使用。它是一种临时机械循环支持装置，主要用于血液动力学不稳定高风险的难治性心源性休克和冠状动脉成形术。本研究的目的,观察性和回顾性性，将在四年（2017-2020年）内进行与该设备使用相关的临床和经济评估。方法：确定与71例患者（51Impella™CP和20Impella™2.5）相关的标准及其临床演变以及住院的成本和评估。结果：特别是，在51例患者中,Impella™CP使18例患者的心肌得以恢复,而在11例患者的更重护理中,Impella™CP是一个中介.在研究期间，支出和估值之间的余额显示赤字为-819,937欧元，然而，有可能改善。结论:Impella™在非常特定的条件下具有临床意义。它的高成本以及除了同质住宿群体之外没有被列入报销清单，这给医疗机构带来了巨大的财务负担。因此，优化未来住宿的评级是必要的。
