COST ANALYSIS OF SHOCK SEVERITY AND VA-ECLS THERAPY IN POST-CARDIOTOMY PATIENTS ACCORDING TO MODIFIED SCAI SHOCK CLASSIFICATION: A MICRO-COSTING APPROACH IN DUTCH POPULATION...
Author(s)
Ufuk Baldan, Marielle van de Veerdonk, MD, PhD, Robert Klautz, Professor, Patrick Klein, MD, PhD.
Amsterdam VUmc, Amsterdam, Netherlands.
Amsterdam VUmc, Amsterdam, Netherlands.
OBJECTIVES: To quantify total postoperative hospital costs and identify cost drivers across modified Society for Cardiovascular Angiography and Interventions (SCAI) SHOCK stages and VA-ECLS therapy.
METHODS: This multicenter, retrospective study included 3,565 cardiac surgery patients treated between January 2021 and June 2024. Patients were stratified to SCAI SHOCK stages A to E on postoperative day one or to intra- or postoperative VA-ECLS. Micro-costing methodology was used and included all transactions exceeding €1,000 or occurring ≥ 20 times during hospital stay. Pre- and intraoperative transactions were excluded. Stage-specific cost estimates were weighted by in-hospital mortality. VA-ECLS costs were stratified according to intra- versus postoperative implementation, including additional personnel requirements and daily therapy surcharges.
RESULTS: Average total postoperative hospital costs of all patients were €16,233. Costs ranged from €11,291 to €36,994 for conservatively treated patients (stages A to E) and from €79,466 to €84,631 for intra- and postoperative VA-ECLS patients. Hospital stay accounted for 70% of total costs. With increasing shock severity, ICU stay accounted for a progressively larger share of total costs.
CONCLUSIONS: This micro-costing analysis of cardiac surgery patients showed that total in-hospital postoperative costs increase progressively with shock severity, with VA‑ECLS patients representing a smaller, more severely ill and non-interchangeable subgroup with substantially higher resource use. Hospital stay, particularly ICU stay, was the main cost driver across all shock stages and was disproportionately higher among VA‑ECLS patients.
METHODS: This multicenter, retrospective study included 3,565 cardiac surgery patients treated between January 2021 and June 2024. Patients were stratified to SCAI SHOCK stages A to E on postoperative day one or to intra- or postoperative VA-ECLS. Micro-costing methodology was used and included all transactions exceeding €1,000 or occurring ≥ 20 times during hospital stay. Pre- and intraoperative transactions were excluded. Stage-specific cost estimates were weighted by in-hospital mortality. VA-ECLS costs were stratified according to intra- versus postoperative implementation, including additional personnel requirements and daily therapy surcharges.
RESULTS: Average total postoperative hospital costs of all patients were €16,233. Costs ranged from €11,291 to €36,994 for conservatively treated patients (stages A to E) and from €79,466 to €84,631 for intra- and postoperative VA-ECLS patients. Hospital stay accounted for 70% of total costs. With increasing shock severity, ICU stay accounted for a progressively larger share of total costs.
CONCLUSIONS: This micro-costing analysis of cardiac surgery patients showed that total in-hospital postoperative costs increase progressively with shock severity, with VA‑ECLS patients representing a smaller, more severely ill and non-interchangeable subgroup with substantially higher resource use. Hospital stay, particularly ICU stay, was the main cost driver across all shock stages and was disproportionately higher among VA‑ECLS patients.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EPH1
Topic
Epidemiology & Public Health
Topic Subcategory
Disease Classification & Coding
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)