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Cost-effectiveness and predictors of early extubation
K V Arom1, R W Emery, R J Petersen
1Minneapolis Heart Institute, Minnesota, USA.
The Annals of Thoracic Surgery
|July 1, 1995
Summary
Early extubation after coronary artery bypass grafting (CABG) significantly reduces hospital costs and length of stay. Predictors of late extubation include older age, female sex, diuretic use, and unstable angina.
Area of Science:
- Cardiothoracic Surgery
- Intensive Care Medicine
- Health Economics
Background:
- Examined predictors and cost-effectiveness of early extubation post-coronary artery bypass grafting (CABG).
- Reviewed 645 patients undergoing CABG in 1993, categorized by extubation time.
Purpose of the Study:
- To identify clinical factors associated with delayed extubation after CABG.
- To evaluate the cost-effectiveness of early versus late extubation in CABG patients.
Main Methods:
- Retrospective review of 645 intensive care unit patients post-CABG.
- Categorization into early (<12 hours), intermediate (12-24 hours), and late (>12 hours) extubation groups.
- Stepwise logistic regression analysis to identify predictors of late extubation.
Main Results:
- Early extubation (<12 hours) achieved in 42% of patients.
- Reintubation rate was less than 1% for the entire cohort.
- Predictors of late extubation (> or = 12 hours) included older age, female sex, preoperative diuretic use, and unstable angina.
Conclusions:
- Early extubation significantly shortens postoperative length of stay.
- Reduced length of stay leads to decreased hospital costs and resource utilization.
- Average hospital charges were approximately $6,000 lower per patient in the early extubation group.