Efficacy and cost-effectiveness of preoperative IABP in patients with ejection fraction of 0.25 or less

The purposes of this study are to determine whether patients with severe left ventricular dysfunction benefit from prophylactic insertion of an intraaortic balloon pump and to evaluate its coste-ffectiveness. Between January 1991 and December 1995, 163 consecutive patients with a left ventricular ej...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:The Annals of thoracic surgery 1996-08, Vol.62 (2), p.401-409
Hauptverfasser: Dietl, Charles A., Berkheimer, Marie D., Woods, Edward L., Gilbert, Christian L., Pharr, William F., Benoit, Charles H.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 409
container_issue 2
container_start_page 401
container_title The Annals of thoracic surgery
container_volume 62
creator Dietl, Charles A.
Berkheimer, Marie D.
Woods, Edward L.
Gilbert, Christian L.
Pharr, William F.
Benoit, Charles H.
description The purposes of this study are to determine whether patients with severe left ventricular dysfunction benefit from prophylactic insertion of an intraaortic balloon pump and to evaluate its coste-ffectiveness. Between January 1991 and December 1995, 163 consecutive patients with a left ventricular ejection fraction of 0.25 or less underwent isolated coronary artery bypass grafting. An intraaortic balloon pump was inserted before operation in 37 patients (group A). The remaining 126 patients underwent operation without preoperative insertion of the device (group B). Preoperatively, 91.9% (34/37) of group A patients and 54.8% (69/126) of group B patients were in New York Heart Association functional class III or IV ( p < 0.001). The 30-day mortality rate was 2.7% (1/37) and 11.9% (15/126) for groups A and B, respectively ( p < 0.005). All deaths occurred in patients in functional class III or IV. In group B, 28 patients (22.2%) required an intraaortic balloon pump after cardiotomy for low cardiac output, 42.9% (12/28) of whom died. Median post-operative hospital stay was 9.9 days and 12.0 days, and mean hospital charges were $50,627 and $54,818 for survivors in groups A and B, respectively ( p = not significant). Our experience suggests that patients with severe left ventricular dysfunction undergoing coronary artery bypass grafting may benefit from preoperative intraaortic balloon pump insertion, especially patients in functional class III or IV. This approach improved survival significantly, reduced hospital stay, and was more cost-effective.
doi_str_mv 10.1016/0003-4975(96)00244-5
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_78190305</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>0003497596002445</els_id><sourcerecordid>78190305</sourcerecordid><originalsourceid>FETCH-LOGICAL-c370t-1122034ded99e541205be67f23574e639ff7538a527b072e819bc74119a89f53</originalsourceid><addsrcrecordid>eNp9kMtOAyEUhonR1Fp9A01YGV2MAgPDsDGpjZcmJrpwTyhzUJp2GGGq8e1l0qZLV3D4Lyd8CJ1TckMJrW4JIWXBlRRXqromhHFeiAM0pkKwomJCHaLx3nKMTlJa5pFleYRGdaW4UPUYfTw4562xv9i0DbYh9QU4B7b339BCSjg43EUIHUQzvOH59P4N-xZ3eYS2T_jH958YlkMktNhFs73kHLlhAoeIV7nnFB05s0pwtjsn6P3x4X32XLy8Ps1n05fClpL0BaWMkZI30CgFglNGxAIq6VgpJIeqVM5JUdZGMLkgkkFN1cJKTqkytXKinKDLbW0Xw9cGUq_XPllYrUwLYZO0zAFSksHIt0YbQ0oRnO6iX5v4qynRA149sNMDO62GIePVQ-xi179ZrKHZh3Y8s3631SH_8dtD1MlmTBYaHzMh3QT__4I_YAKH-g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>78190305</pqid></control><display><type>article</type><title>Efficacy and cost-effectiveness of preoperative IABP in patients with ejection fraction of 0.25 or less</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><source>Alma/SFX Local Collection</source><source>EZB Electronic Journals Library</source><creator>Dietl, Charles A. ; Berkheimer, Marie D. ; Woods, Edward L. ; Gilbert, Christian L. ; Pharr, William F. ; Benoit, Charles H.</creator><creatorcontrib>Dietl, Charles A. ; Berkheimer, Marie D. ; Woods, Edward L. ; Gilbert, Christian L. ; Pharr, William F. ; Benoit, Charles H.</creatorcontrib><description>The purposes of this study are to determine whether patients with severe left ventricular dysfunction benefit from prophylactic insertion of an intraaortic balloon pump and to evaluate its coste-ffectiveness. Between January 1991 and December 1995, 163 consecutive patients with a left ventricular ejection fraction of 0.25 or less underwent isolated coronary artery bypass grafting. An intraaortic balloon pump was inserted before operation in 37 patients (group A). The remaining 126 patients underwent operation without preoperative insertion of the device (group B). Preoperatively, 91.9% (34/37) of group A patients and 54.8% (69/126) of group B patients were in New York Heart Association functional class III or IV ( p &lt; 0.001). The 30-day mortality rate was 2.7% (1/37) and 11.9% (15/126) for groups A and B, respectively ( p &lt; 0.005). All deaths occurred in patients in functional class III or IV. In group B, 28 patients (22.2%) required an intraaortic balloon pump after cardiotomy for low cardiac output, 42.9% (12/28) of whom died. Median post-operative hospital stay was 9.9 days and 12.0 days, and mean hospital charges were $50,627 and $54,818 for survivors in groups A and B, respectively ( p = not significant). Our experience suggests that patients with severe left ventricular dysfunction undergoing coronary artery bypass grafting may benefit from preoperative intraaortic balloon pump insertion, especially patients in functional class III or IV. This approach improved survival significantly, reduced hospital stay, and was more cost-effective.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/0003-4975(96)00244-5</identifier><identifier>PMID: 8694598</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Aged ; Angina, Unstable - surgery ; Angina, Unstable - therapy ; Cardiac Output, Low - classification ; Cardiac Output, Low - surgery ; Cardiac Output, Low - therapy ; Coronary Artery Bypass ; Cost-Benefit Analysis ; Female ; Heart Failure - classification ; Heart Failure - surgery ; Heart Failure - therapy ; Hospital Charges ; Humans ; Intra-Aortic Balloon Pumping - economics ; Length of Stay ; Male ; Multivariate Analysis ; Postoperative Care ; Preoperative Care ; Retrospective Studies ; Risk Factors ; Stroke Volume ; Survival Rate ; Ventricular Dysfunction, Left - prevention &amp; control ; Ventricular Dysfunction, Left - surgery</subject><ispartof>The Annals of thoracic surgery, 1996-08, Vol.62 (2), p.401-409</ispartof><rights>1996 The Society of Thoracic Surgeons</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c370t-1122034ded99e541205be67f23574e639ff7538a527b072e819bc74119a89f53</citedby><cites>FETCH-LOGICAL-c370t-1122034ded99e541205be67f23574e639ff7538a527b072e819bc74119a89f53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0003-4975(96)00244-5$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27926,27927,45997</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8694598$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dietl, Charles A.</creatorcontrib><creatorcontrib>Berkheimer, Marie D.</creatorcontrib><creatorcontrib>Woods, Edward L.</creatorcontrib><creatorcontrib>Gilbert, Christian L.</creatorcontrib><creatorcontrib>Pharr, William F.</creatorcontrib><creatorcontrib>Benoit, Charles H.</creatorcontrib><title>Efficacy and cost-effectiveness of preoperative IABP in patients with ejection fraction of 0.25 or less</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>The purposes of this study are to determine whether patients with severe left ventricular dysfunction benefit from prophylactic insertion of an intraaortic balloon pump and to evaluate its coste-ffectiveness. Between January 1991 and December 1995, 163 consecutive patients with a left ventricular ejection fraction of 0.25 or less underwent isolated coronary artery bypass grafting. An intraaortic balloon pump was inserted before operation in 37 patients (group A). The remaining 126 patients underwent operation without preoperative insertion of the device (group B). Preoperatively, 91.9% (34/37) of group A patients and 54.8% (69/126) of group B patients were in New York Heart Association functional class III or IV ( p &lt; 0.001). The 30-day mortality rate was 2.7% (1/37) and 11.9% (15/126) for groups A and B, respectively ( p &lt; 0.005). All deaths occurred in patients in functional class III or IV. In group B, 28 patients (22.2%) required an intraaortic balloon pump after cardiotomy for low cardiac output, 42.9% (12/28) of whom died. Median post-operative hospital stay was 9.9 days and 12.0 days, and mean hospital charges were $50,627 and $54,818 for survivors in groups A and B, respectively ( p = not significant). Our experience suggests that patients with severe left ventricular dysfunction undergoing coronary artery bypass grafting may benefit from preoperative intraaortic balloon pump insertion, especially patients in functional class III or IV. This approach improved survival significantly, reduced hospital stay, and was more cost-effective.</description><subject>Aged</subject><subject>Angina, Unstable - surgery</subject><subject>Angina, Unstable - therapy</subject><subject>Cardiac Output, Low - classification</subject><subject>Cardiac Output, Low - surgery</subject><subject>Cardiac Output, Low - therapy</subject><subject>Coronary Artery Bypass</subject><subject>Cost-Benefit Analysis</subject><subject>Female</subject><subject>Heart Failure - classification</subject><subject>Heart Failure - surgery</subject><subject>Heart Failure - therapy</subject><subject>Hospital Charges</subject><subject>Humans</subject><subject>Intra-Aortic Balloon Pumping - economics</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Multivariate Analysis</subject><subject>Postoperative Care</subject><subject>Preoperative Care</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stroke Volume</subject><subject>Survival Rate</subject><subject>Ventricular Dysfunction, Left - prevention &amp; control</subject><subject>Ventricular Dysfunction, Left - surgery</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOAyEUhonR1Fp9A01YGV2MAgPDsDGpjZcmJrpwTyhzUJp2GGGq8e1l0qZLV3D4Lyd8CJ1TckMJrW4JIWXBlRRXqromhHFeiAM0pkKwomJCHaLx3nKMTlJa5pFleYRGdaW4UPUYfTw4562xv9i0DbYh9QU4B7b339BCSjg43EUIHUQzvOH59P4N-xZ3eYS2T_jH958YlkMktNhFs73kHLlhAoeIV7nnFB05s0pwtjsn6P3x4X32XLy8Ps1n05fClpL0BaWMkZI30CgFglNGxAIq6VgpJIeqVM5JUdZGMLkgkkFN1cJKTqkytXKinKDLbW0Xw9cGUq_XPllYrUwLYZO0zAFSksHIt0YbQ0oRnO6iX5v4qynRA149sNMDO62GIePVQ-xi179ZrKHZh3Y8s3631SH_8dtD1MlmTBYaHzMh3QT__4I_YAKH-g</recordid><startdate>19960801</startdate><enddate>19960801</enddate><creator>Dietl, Charles A.</creator><creator>Berkheimer, Marie D.</creator><creator>Woods, Edward L.</creator><creator>Gilbert, Christian L.</creator><creator>Pharr, William F.</creator><creator>Benoit, Charles H.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19960801</creationdate><title>Efficacy and cost-effectiveness of preoperative IABP in patients with ejection fraction of 0.25 or less</title><author>Dietl, Charles A. ; Berkheimer, Marie D. ; Woods, Edward L. ; Gilbert, Christian L. ; Pharr, William F. ; Benoit, Charles H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c370t-1122034ded99e541205be67f23574e639ff7538a527b072e819bc74119a89f53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Aged</topic><topic>Angina, Unstable - surgery</topic><topic>Angina, Unstable - therapy</topic><topic>Cardiac Output, Low - classification</topic><topic>Cardiac Output, Low - surgery</topic><topic>Cardiac Output, Low - therapy</topic><topic>Coronary Artery Bypass</topic><topic>Cost-Benefit Analysis</topic><topic>Female</topic><topic>Heart Failure - classification</topic><topic>Heart Failure - surgery</topic><topic>Heart Failure - therapy</topic><topic>Hospital Charges</topic><topic>Humans</topic><topic>Intra-Aortic Balloon Pumping - economics</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Multivariate Analysis</topic><topic>Postoperative Care</topic><topic>Preoperative Care</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stroke Volume</topic><topic>Survival Rate</topic><topic>Ventricular Dysfunction, Left - prevention &amp; control</topic><topic>Ventricular Dysfunction, Left - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dietl, Charles A.</creatorcontrib><creatorcontrib>Berkheimer, Marie D.</creatorcontrib><creatorcontrib>Woods, Edward L.</creatorcontrib><creatorcontrib>Gilbert, Christian L.</creatorcontrib><creatorcontrib>Pharr, William F.</creatorcontrib><creatorcontrib>Benoit, Charles H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dietl, Charles A.</au><au>Berkheimer, Marie D.</au><au>Woods, Edward L.</au><au>Gilbert, Christian L.</au><au>Pharr, William F.</au><au>Benoit, Charles H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy and cost-effectiveness of preoperative IABP in patients with ejection fraction of 0.25 or less</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>1996-08-01</date><risdate>1996</risdate><volume>62</volume><issue>2</issue><spage>401</spage><epage>409</epage><pages>401-409</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><abstract>The purposes of this study are to determine whether patients with severe left ventricular dysfunction benefit from prophylactic insertion of an intraaortic balloon pump and to evaluate its coste-ffectiveness. Between January 1991 and December 1995, 163 consecutive patients with a left ventricular ejection fraction of 0.25 or less underwent isolated coronary artery bypass grafting. An intraaortic balloon pump was inserted before operation in 37 patients (group A). The remaining 126 patients underwent operation without preoperative insertion of the device (group B). Preoperatively, 91.9% (34/37) of group A patients and 54.8% (69/126) of group B patients were in New York Heart Association functional class III or IV ( p &lt; 0.001). The 30-day mortality rate was 2.7% (1/37) and 11.9% (15/126) for groups A and B, respectively ( p &lt; 0.005). All deaths occurred in patients in functional class III or IV. In group B, 28 patients (22.2%) required an intraaortic balloon pump after cardiotomy for low cardiac output, 42.9% (12/28) of whom died. Median post-operative hospital stay was 9.9 days and 12.0 days, and mean hospital charges were $50,627 and $54,818 for survivors in groups A and B, respectively ( p = not significant). Our experience suggests that patients with severe left ventricular dysfunction undergoing coronary artery bypass grafting may benefit from preoperative intraaortic balloon pump insertion, especially patients in functional class III or IV. This approach improved survival significantly, reduced hospital stay, and was more cost-effective.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>8694598</pmid><doi>10.1016/0003-4975(96)00244-5</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0003-4975
ispartof The Annals of thoracic surgery, 1996-08, Vol.62 (2), p.401-409
issn 0003-4975
1552-6259
language eng
recordid cdi_proquest_miscellaneous_78190305
source MEDLINE; Access via ScienceDirect (Elsevier); Alma/SFX Local Collection; EZB Electronic Journals Library
subjects Aged
Angina, Unstable - surgery
Angina, Unstable - therapy
Cardiac Output, Low - classification
Cardiac Output, Low - surgery
Cardiac Output, Low - therapy
Coronary Artery Bypass
Cost-Benefit Analysis
Female
Heart Failure - classification
Heart Failure - surgery
Heart Failure - therapy
Hospital Charges
Humans
Intra-Aortic Balloon Pumping - economics
Length of Stay
Male
Multivariate Analysis
Postoperative Care
Preoperative Care
Retrospective Studies
Risk Factors
Stroke Volume
Survival Rate
Ventricular Dysfunction, Left - prevention & control
Ventricular Dysfunction, Left - surgery
title Efficacy and cost-effectiveness of preoperative IABP in patients with ejection fraction of 0.25 or less
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-17T23%3A29%3A06IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Efficacy%20and%20cost-effectiveness%20of%20preoperative%20IABP%20in%20patients%20with%20ejection%20fraction%20of%200.25%20or%20less&rft.jtitle=The%20Annals%20of%20thoracic%20surgery&rft.au=Dietl,%20Charles%20A.&rft.date=1996-08-01&rft.volume=62&rft.issue=2&rft.spage=401&rft.epage=409&rft.pages=401-409&rft.issn=0003-4975&rft.eissn=1552-6259&rft_id=info:doi/10.1016/0003-4975(96)00244-5&rft_dat=%3Cproquest_cross%3E78190305%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=78190305&rft_id=info:pmid/8694598&rft_els_id=0003497596002445&rfr_iscdi=true