急性心肌梗死(AMI-CS)引起的心源性休克与显著的短期和长期发病率和死亡率相关。尽管如此,对相关成本知之甚少。
■本研究的目的是使用安大略省的行政数据评估与AMI-CS相关的医疗保健成本和资源使用,加拿大。
■这是一项2009年4月至2019年3月的成人AMI-CS患者的回顾性队列研究。指数录取后的一年费用是在个人层面报告的。我们使用广义线性模型来识别与成本增加相关的因素。我们通过血运重建策略对患者进行分层,以比较每组的费用,并检查每个财政年度患者水平的总费用。
■我们纳入了安大略省135个中心的9,789名连续AMI-CS患者(平均年龄70.5岁;67.7%为男性)。住院死亡率为30.2%,2年死亡率为45.9%。每位患者的住院费用中位数为$23,912(IQR:$12,234-$41,833),1年总费用中位数为$37,913(IQR:$20,113-$66,582)。在医院死亡的人的1年费用中位数为$17,730(IQR:$9,323-$38,379),和$45,713(IQR:$29,688-$77,683),出院后发生$12,719(IQR:$4,262-$35,275)。接受冠状动脉旁路移植术的患者在血运重建组中的费用最高。从2009年到2019年,每个财政年度的成本没有显着差异。
■AMI-CS与巨大的医疗保健成本相关,在住院期间和出院后。为了优化成本效益,未来的治疗方法除了提高死亡率外,还应致力于减少残疾.
UNASSIGNED: Cardiogenic shock due to acute myocardial infarction (AMI-CS) is associated with significant short- and long-term morbidity and mortality. Despite this, little is known about associated cost.
UNASSIGNED: The purpose of this
study was to evaluate the health care costs and resource use associated with AMI-CS using administrative data from the province of Ontario, Canada.
UNASSIGNED: This was a retrospective cohort
study of adult patients with AMI-CS from April 2009 to March 2019. One-year costs following index admission were reported at an individual level. We used generalized linear models to identify factors associated with increased cost. We stratified patients by revascularization strategy to compare cost in each group and examined total cost at a patient level per individual fiscal year.
UNASSIGNED: We included 9,789 consecutive patients with AMI-CS across 135 centers in Ontario (mean age 70.5 years; 67.7% male). Mortality in-hospital was 30.2%, and mortality at 2 years was 45.9%. The median inpatient cost per patient was $23,912 (IQR: $12,234-$41,833) with a median total 1-year cost of $37,913 (IQR: $20,113-$66,582). The median 1-year cost was $17,730 (IQR: $9,323-$38,379) for those who died in hospital, and $45,713 (IQR: $29,688-$77,683) for those surviving to discharge, with $12,719 (IQR: $4,262-$35,275) occurring after discharge. Patients who received coronary artery bypass grafting incurred the highest cost among revascularization groups. No significant differences were observed in cost per fiscal year from 2009 to 2019.
UNASSIGNED: AMI-CS is associated with significant health care costs, both during the index hospitalization and following discharge. To optimize cost-effectiveness, future therapies should aim to reduce disability in addition to improving mortality.