Related Experiment Video
Updated: May 12, 2026
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
OPCAB surgery is cost-effective for elderly patients
Kim Houlind1, Bo Juul Kjeldsen, Susanne Nørgaard Madsen
1Department of Cardiothoracic Surgery, Skejby Hospital, Aarhus University Hospital, Aarhus, Denmark. kim.christian.houlind@slb.regionsyddanmark.dk
Objective:
To determine the cost-effective operative strategy for coronary artery bypass surgery in patients above 70 years.
Design:
Randomized, controlled trial of 900 patients above 70 years of age subjected to coronary artery bypass surgery. Patients were randomized to either on-pump or off-pump coronary artery bypass surgery. Data on direct and indirect costs were prospectively collected. Preoperatively and six months postoperatively, quality of life was assessed using EuroQol-5D questionnaires. Perioperative in-hospital costs and costs of re-intervention were included.
Results:
The Summary Score of EuroQol-5D increased in both groups between preoperatively and postoperatively. In the on-pump group, it increased from 0.75 (0.16) (mean (SD)) to 0.84 (0.17), while the increase in the off-pump group was from 0.75 (0.15) to 0.84 (0.18). The difference between the groups was 0.0016 QALY and not significantly different. The mean costs were 148.940 D.Kr (CI, 130.623 D.Kr-167.252 D.Kr) for an on-pump patient and 138.693 D.Kr (CI, 123.167 D.Kr-154.220 D.Kr) for an off-pump patient. The ICER base-case point estimate was 6,829,999 D.Kr/QALY. The cost-effectiveness acceptability curve showed 89% probability of off-pump being cost-effective at a threshold value of 269,400 D.Kr/QALY.
Conclusions:
Off-pump surgery tends to be more cost-effective than on-pump surgery. Long-term comparisons are warranted.
