Long-term Resource Utilization and Survival After Major Amputation for Critical Limb Ischemia

Abstract

direct and indirect hospital costs of the initial and subsequent reinterventions was applied to a prospectively collected vascular database. Analysis was done via Student t test and log-ranked Kaplan-Meier analysis. Results: The mean length in the ER group was 18.5 cm. A prosthetic conduit was used in 51% of SR group. Patency at 1 year was similar in both groups and superior for SR thereafter. The rate of all reinterventions was 28 of 85 (33%) in ER and 40 of 98 (41%) in SR. The average hospital costs for the SR group were significantly greater than costs for the ER group ($18,506 $,877 vs $11,740 $709, P .005); however, this difference was not significant when comparing amortized costs per day of patency at 1 year ($82 $21 vs $136 103), 2 years ($55 $28 vs $152 134), 3 years ($56 $44 vs $16 3), or 4 years ($8 $1 vs $10 $2) in patients with claudication or chronic limb ischemia. Conclusions: The amortized cost/day model is valuable for evaluating resource utilization, enabling us to examine the cost efficacy of the procedure, patency, and reinterventions. Our findings indicate that although initially endovascular therapy for femoropopliteal occlusive disease is associated with significant savings, long term the amortized cost per day is comparable in selected patients undergoing ER or SR.