%0 Journal Article
%T Cumulative In-Hospital Costs Associated With Single-Ventricle Palliation.
%A O'Byrne ML
%A McHugh KE
%A Huang J
%A Song L
%A Griffis H
%A Anderson BR
%A Bucholz EM
%A Chanani NK
%A Elhoff JJ
%A Handler SS
%A Jacobs JP
%A Li JS
%A Lewis AB
%A McCrindle BW
%A Pinto NM
%A Sassalos P
%A Spar DS
%A Pasquali SK
%A Glatz AC
%J JACC Adv
%V 1
%N 2
%D 2022 Jun
%M 38939312
暂无%R 10.1016/j.jacadv.2022.100029
%X <B>UNASSIGNED: </B>In the SVR (Single Ventricle Reconstruction) Trial, 1-year survival in recipients of right ventricle to pulmonary artery shunts (RVPAS) was superior to that in those receiving modified Blalock-Taussig-Thomas shunts (MBTTS), but not in subsequent follow-up. Cost analysis is an expedient means of evaluating value and morbidity.<BR><B>UNASSIGNED: </B>The purpose of this study was to evaluate differences in cumulative hospital costs between RVPAS and MBTTS.<BR><B>UNASSIGNED: </B>Clinical data from SVR and costs from Pediatric Health Information Systems database were combined. Cumulative hospital costs and cost-per-day-alive were compared serially at 1, 3, and 5 years between RVPAS and MBTTS. Potential associations between patient-level factors and cost were explored with multivariable models.<BR><B>UNASSIGNED: </B>In total, 303 participants (55% of the SVR cohort) from 9 of 15 sites were studied (48% MBTTS). Observed total costs at 1 year were lower for MBTTS ($701,260 ± 442,081) than those for RVPAS ($804,062 ± 615,068), a difference that was not statistically significant (P = 0.10). Total costs were also not significantly different at 3 and 5 years (P = 0.21 and 0.32). Similarly, cost-per-day-alive did not differ significantly for either group at 1, 3, and 5 years (all P > 0.05). In analyses of transplant-free survivors, total costs and cost-per-day-alive were higher for RVPAS at 1 year (P = 0.05 for both) but not at 3 and 5 years (P > 0.05 for all). In multivariable models, aortic atresia and prematurity were associated with increased cost-per-day-alive across follow-up (P < 0.05).<BR><B>UNASSIGNED: </B>Total costs do not differ significantly between MBTTS and RVPAS. The magnitude of longitudinal costs underscores the importance of efforts to improve outcomes in this vulnerable population.