ASSOCIATION BETWEEN INTRA- AND POST-OPERATIVE SURGICAL COMPLICATIONS AND HEALTH ECONOMIC OUTCOMES IN PATIENTS UNDERGOING OPEN HEART VALVE REPLACEMENT: A RETROSPECTIVE DATABASE ANALYSIS
Author(s)
Barbara H. Johnson, MBA1, Prinieeth Anand d, BE2, Elena Naoumtchik, MS3, Carolina Castagna, MD, PhD4, Najmuddin Gunja, MBA, PhD5, Stephen Johnston, PhD6, Niels-Derrek Schmitz, MD7;
1Johnson & Johnson, Associate Director, MedTech Epidemiology and Real World Data Sciences, Lincoln, NH, USA, 2Mu Sigma, Bangalore, India, 3Johnson & Johnson, Markham, ON, Canada, 4Johnson & Johnson, Raritan, NJ, USA, 5J&J Medical Devices, Markham, ON, Canada, 6Johnson & Johnson, Annapolis, MD, USA, 7Johnson & Johnson, Norderstedt, Germany
1Johnson & Johnson, Associate Director, MedTech Epidemiology and Real World Data Sciences, Lincoln, NH, USA, 2Mu Sigma, Bangalore, India, 3Johnson & Johnson, Markham, ON, Canada, 4Johnson & Johnson, Raritan, NJ, USA, 5J&J Medical Devices, Markham, ON, Canada, 6Johnson & Johnson, Annapolis, MD, USA, 7Johnson & Johnson, Norderstedt, Germany
OBJECTIVES: To quantify the association between selected intra- and post-operative surgical complications and health economic outcomes for patients undergoing open heart valve replacement in the US.
METHODS: This retrospective observational study used the Premier Healthcare Database. Eligible patients were aged ≥18 undergoing open heart valve replacement between 1/2016-12/2024. Surgical complications included bleeding (a composite of either a diagnosis related to acute post-hemorrhagic anemia, hemorrhage, hematoma, and/or a procedure code for transfusion) and a composite of wound dehiscence/surgical site infection (WD-SSI). Outcomes included length of stay (LOS), total hospital costs through 30-days post-discharge (30-day costs), and all-cause 30-day readmissions. Multivariable generalized linear models were used to quantify the association of surgical complications (measured at index for LOS and at index through 30 days for 30-day costs and readmissions) with the study outcomes, adjusting for patient characteristics (e.g., age, sex), procedural (e.g., valve: aortic/mitral/pulmonary/tricuspid, secondary CABG), and hospital/provider characteristics (e.g., hospital bed size, teaching status).
RESULTS: Data from 135,545 patients were analyzed; 62.5% male, mean age 64.3 (SD=12.8) years, 74% aortic valve. The incidence of bleeding and WD-SSI at index were 64.8% and 0.75%, and at index-through-30-days were 65.5% and 1.9% respectively. After multivariable adjustment, mean LOS among patients with evidence of bleeding and WD-SSI was significantly longer than among patients without ([11.1 v 9.6 days] and [26.3 v 10.5 days], respectively, both p<0.001). Mean 30-day costs among patients with evidence of bleeding and WD-SSI were significantly higher than among patients without ($79,916 v $68,785] and [$139,853 v $75,468], respectively, both p<0.001). Readmission rates among patients with evidence of bleeding and WD-SSI were significantly higher than among patients without ([11.7% v 8.3%] and [51.0% v 10.1%], respectively, both p<0.001).
CONCLUSIONS: In this retrospective study of patients undergoing open heart valve replacement in the US, surgical complications were not uncommon and associated with significant health economic burden.
METHODS: This retrospective observational study used the Premier Healthcare Database. Eligible patients were aged ≥18 undergoing open heart valve replacement between 1/2016-12/2024. Surgical complications included bleeding (a composite of either a diagnosis related to acute post-hemorrhagic anemia, hemorrhage, hematoma, and/or a procedure code for transfusion) and a composite of wound dehiscence/surgical site infection (WD-SSI). Outcomes included length of stay (LOS), total hospital costs through 30-days post-discharge (30-day costs), and all-cause 30-day readmissions. Multivariable generalized linear models were used to quantify the association of surgical complications (measured at index for LOS and at index through 30 days for 30-day costs and readmissions) with the study outcomes, adjusting for patient characteristics (e.g., age, sex), procedural (e.g., valve: aortic/mitral/pulmonary/tricuspid, secondary CABG), and hospital/provider characteristics (e.g., hospital bed size, teaching status).
RESULTS: Data from 135,545 patients were analyzed; 62.5% male, mean age 64.3 (SD=12.8) years, 74% aortic valve. The incidence of bleeding and WD-SSI at index were 64.8% and 0.75%, and at index-through-30-days were 65.5% and 1.9% respectively. After multivariable adjustment, mean LOS among patients with evidence of bleeding and WD-SSI was significantly longer than among patients without ([11.1 v 9.6 days] and [26.3 v 10.5 days], respectively, both p<0.001). Mean 30-day costs among patients with evidence of bleeding and WD-SSI were significantly higher than among patients without ($79,916 v $68,785] and [$139,853 v $75,468], respectively, both p<0.001). Readmission rates among patients with evidence of bleeding and WD-SSI were significantly higher than among patients without ([11.7% v 8.3%] and [51.0% v 10.1%], respectively, both p<0.001).
CONCLUSIONS: In this retrospective study of patients undergoing open heart valve replacement in the US, surgical complications were not uncommon and associated with significant health economic burden.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE293
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), STA: Surgery