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Costs of excessive postoperative hemorrhage in cardiac surgery

Michael C Christensen1, Stephan Krapf, Angela Kempel

  • 1Global Development, Novo Nordisk A/S, Bagsvaerd, Denmark. mcrc@novonordisk.com

The Journal of Thoracic and Cardiovascular Surgery
|August 25, 2009
PubMed

Insights

Excessive postoperative hemorrhage in cardiac surgery significantly increases hospital costs and patient mortality. Preventing bleeding in cardiac surgery patients can offer substantial cost-effectiveness benefits.

Area of Science:

  • Cardiovascular Surgery
  • Health Economics
  • Patient Safety

Background:

  • Excessive postoperative hemorrhage is a critical complication in cardiac surgery.
  • This complication places significant demands on hospital resources and patient outcomes.
  • Understanding the economic impact is crucial for resource allocation and quality improvement.

Purpose of the Study:

  • To quantify the exact impact of postoperative hemorrhage on hospital costs in Germany.
  • To analyze the association between hemorrhage and patient outcomes.
  • To determine the incremental costs attributable to excessive bleeding.

Main Methods:

  • Retrospective analysis of prospectively collected data from a German Quality Assurance Database.
  • Comparison of resource consumption in patients with and without excessive postoperative hemorrhage.
  • Multivariate regression analysis to identify incremental costs, adjusting for confounding factors.

Main Results:

  • Six percent of 1118 cardiac surgery patients experienced excessive postoperative hemorrhage.
  • Hemorrhage significantly increased risks of complications, reoperation, prolonged ICU stay, ventilation, and blood transfusions.
  • Mortality was 22% in hemorrhage patients vs. 6% in others (P < .0001).
  • Incremental costs were €6251 per patient (95% CI, 4594-7909).

Conclusions:

  • Excessive postoperative hemorrhage in cardiac surgery incurs substantial hospital costs in Germany.
  • Hemorrhage is strongly linked to increased patient morbidity and mortality.
  • Interventions to prevent or manage hemorrhage likely possess significant cost-effectiveness potential.
Abstract

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