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Hospital costs and prognosis in end-stage renal disease patients receiving coronary artery bypass grafting
Journal
BMC Nephrology
Journal Volume
21
Journal Issue
1
Date Issued
2020
Author(s)
Abstract
Background: Coronary artery disease is common in patients with end-stage renal disease (ESRD). Patients with ESRD are a high-risk group for cardiac surgery and have increased morbidity and mortality. Most studies comparing ESRD patients receiving coronary artery bypass grafting (CABG) or percutaneous coronary intervention have found that the long-term survival is good in ESRD patients after CABG. The aim of our study was to compare ESRD patients who underwent CABG with the general population who underwent CABG, in terms of prognosis and hospital costs. Methods: This study analyzed data from the National Health Insurance Research Database in Taiwan for patients who were diagnosed with ESRD and received CABG (ICD-9-CM codes 585 or 586) between January 1, 2004, and December 31, 2009. The ESRD patients included in this study all received catastrophic illness cards with the major illness listed as ESRD from the Ministry of Health and Welfare in Taiwan. The control subjects were randomly selected patients without ESRD after propensity score matching with ESRD patients according to age, gender, and comorbidities at a 2:1 ratio from the same dataset. Results: A total of 48 ESRD patients received CABG, and their mean age was 62.04 ± 10.04 years. Of these patients, 29.2% were aged ?70 years, and 66.7% were male. ESRD patients had marginally higher intensive care unit (ICU) stays (11.06 vs 7.24 days) and significantly higher ICU costs (28,750 vs 17,990 New Taiwan Dollars (NTD)) than non-ESRD patients. Similarly, ESRD patients had significantly higher surgical costs (565,200 vs. 421,890 NTD), a higher perioperative mortality proportion (10.4% vs 2.1%) and a higher postoperative mortality proportion (33.3% vs 11.5%) than non-ESRD patients. Conclusions: After CABG, ESRD patients had a higher risk of mortality than non-ESRD patients, and ICU and surgery costs were also higher among the ESRD patients than among patients without ESRD. ? 2020 The Author(s).
Subjects
Coronary artery bypass grafting; End-stage renal disease; Hospital costs; Prognosis
SDGs
Other Subjects
adult; age; aged; Article; comorbidity; controlled study; coronary artery bypass graft; coronary artery disease; end stage renal disease; female; gender; high risk patient; hospital cost; human; ICD-9-CM; intensive care unit; major clinical study; male; mortality; mortality risk; patient selection; prognosis; propensity score; retrospective study; Taiwan; artificial ventilation; case control study; chronic kidney failure; complication; coronary artery bypass graft; coronary artery disease; economics; health care cost; length of stay; middle aged; prognosis; Adult; Aged; Case-Control Studies; Coronary Artery Bypass; Coronary Artery Disease; Female; Health Expenditures; Hospital Costs; Humans; Intensive Care Units; Kidney Failure, Chronic; Length of Stay; Male; Middle Aged; Prognosis; Respiration, Artificial
Publisher
BioMed Central Ltd
Type
journal article