Direct health costs and clinical outcomes of open surgery in patients with abdominal aortic aneurysm in Spain. The RECAPTA study

ABSTRACT

Objective: Abdominal aortic aneurysm (AAA) is a chronic, progressive disease that often requires surgical repair. This study aimed to assess the healthcare costs and clinical outcomes of open AAA repair in Spain.

Method: Observational, retrospective, multicenter study with a one-year follow-up. Healthcare resource use and costs related to the surgical procedure, hospital stay, and follow-up period were assessed.

Results: Ninety patients with asymptomatic AAA who underwent open repair were recruited between 2003 and 2009 at three Spanish hospitals. Four patients (4.44%) died in the first 30 postoperative days. Mean [standard deviation] procedure time was 292.83 [72.10] minutes and mean hospital length of stay was 11.44 days [5.42]. Thirty two patients (35.56%) presented in-hospital complications and three patients (3.45%) underwent re-intervention during follow-up. The mean overall cost per patient during the study period was €21,622.59, of which 42.40% (€9,168.19), 52.08% (€11,261.74), and 5.52% (€1,192.66) corresponded to the surgical procedure, the inpatient stay, and the study follow-up period, respectively.

Conclusions: Given the economic burden imposed by the treatment of patients admitted with AAA on the Spanish health system, additional efforts comparing the cost of open repair with endovascular treatments are needed to ensure greater efficiency.

KEYWORDS:

• Open surgery
• abdominal aorta aneurysm
• cost
• Spain
• RECAPTA

Acknowledgments

The authors acknowledge publishing and project management assistance provided by Oblikue Consulting, SL, Barcelona, Spain (funded by Medtronic Ibérica, SA).

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Declaration of Interest

M Egea and M Álvarez are employees of Medtronic Ibérica, S.A. R Fernández-Samos, J Antonio Lechón, L Reparaz and M Cairols acknowledge research grants from Medtronic Ibérica SA. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Ethics approval

The study protocol was approved by the Clinical Research Ethics Committees of all participating hospitals.

Author Contributions

All authors conceived the manuscript and reviewed, edited and made significant contributions to the final manuscript.

Additional information

Funding

This study was funded by Medtronic Ibérica, SA