Comparison of Index Hospitalization Costs between Robotic CABG and Conventional CABG: Implications for Hybrid Coronary Revascularization

Galina Leyvi, Clyde B. Schechter, Sankalp Sehgal, Mark A. Greenberg, Max Snyder, Stephen Forest, Alec Mais, Nan Wang, Patrice Deleo, Joseph J. Derose

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Objectives To compare the direct costs of the index hospitalization and 30-day morbidity and mortality incurred during robotic and conventional coronary artery bypass grafting at a single institution based on hospital clinical and financial records. Design Retrospective study, propensity-matched groups with one-to-one nearest neighbor matching. Setting University hospital, a tertiary care center. Participants Two thousand eighty-eight consecutive patients who underwent primary coronary artery bypass grafting (CABG) from January 2007 to March 2012. Interventions One hundred forty-one matched pairs were created and analyzed. Measurements and Main Results Robotic CABG was associated with a decrease in operative time (5.61±1.1 v 6.6±1.15 hours, p<0.001), a lower need for blood transfusion (12.8% v 22.6%, p = 0.04), a shorter length of stay (6 [4-9]) v 7 [5-11] days, p = 0.001), a shorter ICU stay (31 [24-49] hours v 52 [32-96.5] hours, p<0.001) and lower NY state complications composite rate (4.26% v 13.48%, p = 0.01). In spite of that, the cost of robotic procedures was not significantly different from matched conventional cases ($18,717.35 [11,316.1-34,550.6] versus $18,601 [13,137-50,194.75], p = 0.13), except 26 hybrid coronary revascularizations in which angioplasty was performed on the same admission (hybrid 25,311.1 [18,537.1-41,167.85] versus conventional 18,966.13 [13,337.75-56,021.75], p = 0.02). Conclusion Robotically assisted CABG does not increase the cost of the index hospitalization when compared to conventional CABG unless hybrid revascularization is performed on the same admission.

Original languageEnglish (US)
Pages (from-to)12-18
Number of pages7
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume30
Issue number1
DOIs
StatePublished - Jan 1 2016

Keywords

  • CABG
  • PCI
  • coronary stent
  • healthcare costs
  • minimally invasive surgery
  • robotic surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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