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Operations, total hospital stay and costs of critical leg ischemia. A population-based longitudinal outcome study of 321 patients

Eneroth, Magnus LU ; Apelqvist, Jan LU ; Troëng, Thomas and Persson, Björn M. (1996) In Acta Orthopaedica Scandinavica 67(5). p.459-465
Abstract

In a longitudinal analysis of all 321 patients in a defined population having surgery for critical leg ischemia during 1 year in Malmohus county (0.53 million inhabitants), Sweden, we investigated all vascular procedures and amputations on both legs, total hospital stay and hospital costs from the first procedure in each patient until death or at follow-up at least 6 years postoperatively. The first (key) operation during the inclusion year was a reconstructive vascular procedure in 96 patients, a restorative vascular procedure in 111 and a major amputation in 114 patients. One third of those with a reconstructive and half of those with a restorative key procedure had an ipsilateral major amputation. The mean number of surgical... (More)

In a longitudinal analysis of all 321 patients in a defined population having surgery for critical leg ischemia during 1 year in Malmohus county (0.53 million inhabitants), Sweden, we investigated all vascular procedures and amputations on both legs, total hospital stay and hospital costs from the first procedure in each patient until death or at follow-up at least 6 years postoperatively. The first (key) operation during the inclusion year was a reconstructive vascular procedure in 96 patients, a restorative vascular procedure in 111 and a major amputation in 114 patients. One third of those with a reconstructive and half of those with a restorative key procedure had an ipsilateral major amputation. The mean number of surgical procedures and length of hospital stay among all patients were 3 (1-19) procedures and 117 (1-1097) days, respectively, Of the total number of days in hospital, less than half were in surgical departments, 10% in other acute-care departments and almost half in rehabilitation clinics and nursing homes. The total hospital and surgical costs among all patients were USD 15.1 million (mean USD 47,000/patient), with no significant differences in relation to the key operation. We conclude that patients who have undergone surgery for critical leg ischemia accumulate very high total long-term hospital costs due to the need for repetitive surgery and long hospital stays. Our findings also show that a longitudinal study, including hospital stay in departments other than surgical, is necessary for a correct cost-and-outcome analysis.

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author
publishing date
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Contribution to journal
publication status
published
in
Acta Orthopaedica Scandinavica
volume
67
issue
5
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • scopus:0029807467
ISSN
0001-6470
language
English
LU publication?
no
id
560247b2-eab7-4628-bacb-22aadbaed406
date added to LUP
2017-03-29 09:11:08
date last changed
2017-07-30 05:23:33
@article{560247b2-eab7-4628-bacb-22aadbaed406,
  abstract     = {<p>In a longitudinal analysis of all 321 patients in a defined population having surgery for critical leg ischemia during 1 year in Malmohus county (0.53 million inhabitants), Sweden, we investigated all vascular procedures and amputations on both legs, total hospital stay and hospital costs from the first procedure in each patient until death or at follow-up at least 6 years postoperatively. The first (key) operation during the inclusion year was a reconstructive vascular procedure in 96 patients, a restorative vascular procedure in 111 and a major amputation in 114 patients. One third of those with a reconstructive and half of those with a restorative key procedure had an ipsilateral major amputation. The mean number of surgical procedures and length of hospital stay among all patients were 3 (1-19) procedures and 117 (1-1097) days, respectively, Of the total number of days in hospital, less than half were in surgical departments, 10% in other acute-care departments and almost half in rehabilitation clinics and nursing homes. The total hospital and surgical costs among all patients were USD 15.1 million (mean USD 47,000/patient), with no significant differences in relation to the key operation. We conclude that patients who have undergone surgery for critical leg ischemia accumulate very high total long-term hospital costs due to the need for repetitive surgery and long hospital stays. Our findings also show that a longitudinal study, including hospital stay in departments other than surgical, is necessary for a correct cost-and-outcome analysis.</p>},
  author       = {Eneroth, Magnus and Apelqvist, Jan and Troëng, Thomas and Persson, Björn M.},
  issn         = {0001-6470},
  language     = {eng},
  number       = {5},
  pages        = {459--465},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica Scandinavica},
  title        = {Operations, total hospital stay and costs of critical leg ischemia. A population-based longitudinal outcome study of 321 patients},
  volume       = {67},
  year         = {1996},
}