PMID- 32115823
OWN - NLM
STAT- MEDLINE
DCOM- 20200928
LR  - 20200928
IS  - 1540-8191 (Electronic)
IS  - 0886-0440 (Linking)
VI  - 35
IP  - 4
DP  - 2020 Apr
TI  - Utilizing the index for mortality prediction after cardiac transplantation risk 
      score to predict hospital resource consumption.
PG  - 854-859
LID - 10.1111/jocs.14486 [doi]
AB  - OBJECTIVE: The index for mortality prediction after cardiac transplantation 
      (IMPACT) risk score incorporates 12 preoperative recipient-specific variables, 
      and has been validated as an accurate predictor of short- and long-term mortality 
      after orthotopic heart transplantation (OHTx). We believe it can also be used to 
      predict hospital costs, and we hypothesize that higher preoperative IMPACT risk 
      scores are associated with increased hospital resource consumption. METHODS: All 
      OHTx patients >/=18 years of age at our institution were reviewed from 1 January 
      2000 to 31 December 2014. Total index hospitalization costs post-transplant were 
      extracted and presented in 2014 consumer price index inflation-adjusted US 
      dollars. Patients were stratified into quartiles (Q) according to IMPACT risk 
      scores. Logarithmic transformation normalized cost data, and linear regression 
      assessed for correlation. A comparison of cost between Q of IMPACT risk score was 
      performed using rank-sum and Kruskal-Wallis tests. Survival was estimated using 
      the Kaplan-Meier method. RESULTS: Three hundred fifty-six (n = 356) OHTx were 
      performed during the study period. The median IMPACT score for the cohort was 
      five (interquartile range [IQR] 3-6). Eight (2.2%) patients died within 30-days 
      and 1-year Kaplan-Meier survival was 88.3%. The median length of stay (LOS) was 
      16 (IQR 14-24) days. The median hospital cost for index admission was $222 200 
      (IQR:$169 200-$313 700). Median LOS was longer in Q4 vs Q1 (18 days vs 15 days, 
      P = .01) and index hospital costs in Q4 were significantly higher compared to Q1 
      patients ($280 400 vs $205 000, P < .01). There was a significant positive 
      correlation between IMPACT risk score and cost (regression coefficient .04, 
      P < .01). CONCLUSION: This is the first study in adult cardiac transplantation to 
      identify a positive correlation between hospital cost and recipient risk using 
      the IMPACT risk score. Cost and resource consumption for the index admission 
      after OHTx were significantly higher in the highest IMPACT risk Q compared with 
      patients in the lowest Q.
CI  - (c) 2020 Wiley Periodicals, Inc.
FAU - Jeng, Eric I
AU  - Jeng EI
AUID- ORCID: 0000-0002-3824-9958
AD  - Division of Thoracic and Cardiovascular Surgery, College of Medicine, University 
      of Florida, Gainesville, Florida.
FAU - Hall, David J
AU  - Hall DJ
AD  - Division of Thoracic and Cardiovascular Surgery, College of Medicine, University 
      of Florida, Gainesville, Florida.
FAU - Vilaro, Juan
AU  - Vilaro J
AD  - Division of Cardiovascular Medicine, College of Medicine, University of Florida, 
      Gainesville, Florida.
FAU - Lipori, Paul
AU  - Lipori P
AD  - Finance, University of Florida-Shands, Gainesville, Florida.
FAU - Parker, Alex
AU  - Parker A
AD  - Division of Cardiovascular Medicine, College of Medicine, University of Florida, 
      Gainesville, Florida.
FAU - Ahmed, Mustafa
AU  - Ahmed M
AUID- ORCID: 0000-0003-2781-7873
AD  - Division of Cardiovascular Medicine, College of Medicine, University of Florida, 
      Gainesville, Florida.
FAU - Aranda, Juan M Jr
AU  - Aranda JM Jr
AD  - Division of Cardiovascular Medicine, College of Medicine, University of Florida, 
      Gainesville, Florida.
FAU - Martin, Tomas D
AU  - Martin TD
AD  - Division of Thoracic and Cardiovascular Surgery, College of Medicine, University 
      of Florida, Gainesville, Florida.
FAU - Beaver, Thomas M
AU  - Beaver TM
AD  - Division of Thoracic and Cardiovascular Surgery, College of Medicine, University 
      of Florida, Gainesville, Florida.
FAU - Arnaoutakis, George J
AU  - Arnaoutakis GJ
AUID- ORCID: 0000-0002-7648-0747
AD  - Division of Thoracic and Cardiovascular Surgery, College of Medicine, University 
      of Florida, Gainesville, Florida.
LA  - eng
PT  - Journal Article
DEP - 20200301
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Economics/*statistics & numerical data
MH  - Female
MH  - Health Resources/*economics/*statistics & numerical data
MH  - Heart Failure/*economics/*surgery
MH  - Heart Transplantation/*economics/*mortality
MH  - *Hospital Costs
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Preoperative Period
MH  - Quality of Health Care/statistics & numerical data
MH  - Risk
MH  - Survival Rate
MH  - Time Factors
MH  - Young Adult
OTO - NOTNLM
OT  - congestive heart failure
OT  - hospital resource consumption
OT  - orthotopic heart transplant
EDAT- 2020/03/03 06:00
MHDA- 2020/09/29 06:00
CRDT- 2020/03/03 06:00
PHST- 2020/03/03 06:00 [pubmed]
PHST- 2020/09/29 06:00 [medline]
PHST- 2020/03/03 06:00 [entrez]
AID - 10.1111/jocs.14486 [doi]
PST - ppublish
SO  - J Card Surg. 2020 Apr;35(4):854-859. doi: 10.1111/jocs.14486. Epub 2020 Mar 1.