Skip to content Skip to navigation
University of Warwick
  • Study
  • |
  • Research
  • |
  • Business
  • |
  • Alumni
  • |
  • News
  • |
  • About

University of Warwick
Publications service & WRAP

Highlight your research

  • WRAP
    • Home
    • Search WRAP
    • Browse by Warwick Author
    • Browse WRAP by Year
    • Browse WRAP by Subject
    • Browse WRAP by Department
    • Browse WRAP by Funder
    • Browse Theses by Department
  • Publications Service
    • Home
    • Search Publications Service
    • Browse by Warwick Author
    • Browse Publications service by Year
    • Browse Publications service by Subject
    • Browse Publications service by Department
    • Browse Publications service by Funder
  • Help & Advice
University of Warwick

The Library

  • Login
  • Admin

Procedural and 12 month in-hospital costs of primary infra-popliteal bypass surgery, infra-popliteal best endovascular treatment, and major lower limb amputation for chronic limb threatening ischaemia

Tools
- Tools
+ Tools

Popplewell, Matthew A., Andronis, Lazaros, Davies, Huw O. B., Meecham, Lewis, Kelly, Lisa, Bate, Gareth and Bradbury, Andrew W. (2021) Procedural and 12 month in-hospital costs of primary infra-popliteal bypass surgery, infra-popliteal best endovascular treatment, and major lower limb amputation for chronic limb threatening ischaemia. Journal of Vascular Surgery, 75 (1). pp. 195-204. doi:10.1016/j.jvs.2021.07.232 ISSN 0741-5214.

[img]
Preview
PDF
WRAP-procedural-12-month-in-hospital-costs-primary-infra-popliteal-bypass-surgery-Andronis-2021.pdf - Accepted Version - Requires a PDF viewer.
Available under License Creative Commons Attribution Non-commercial No Derivatives 4.0.

Download (418Kb) | Preview
Official URL: https://doi.org/10.1016/j.jvs.2021.07.232

Request Changes to record.

Abstract

Objective:
Chronic limb-threatening ischemia (CLTI) is a growing global problem due to the widespread use of tobacco and increasing prevalence of diabetes. Although the financial consequences are considerable, few studies have compared the relative cost-effectiveness of different CLTI management strategies. The Bypass vs Angioplasty in Severe Ischaemia of the Leg (BASIL)-2 trial is randomizing patients with CLTI to primary infra-popliteal (IP) vein bypass surgery (BS) or best endovascular treatment (BET) and includes a comprehensive within-trial cost-utility analysis. The aim of this study is to compare over a 12-month time horizon, the costs of primary IP BS, IP best endovascular treatment (BET), and major limb major amputation (MLLA) to inform the BASIL-2 cost-utility analysis.

Methods:
We compared procedural human resource (HR) costs and total in-hospital costs for the index admission, and over the following 12-months, in 60 consecutive patients undergoing primary IP BS (n = 20), IP BET (n = 20), or MLLA (10 transfemoral and 10 transtibial) for CLTI within the BASIL prospective cohort study.
Results

Procedural:
HR costs were greatest for BS (BS £2551; 95% confidence interval [CI], £1934-£2807 vs MLLA £1130; 95% CI, £1046-£1297 vs BET £329; 95% CI, £242-£390; P < .001, Kruskal-Wallis) due to longer procedure duration and greater staff requirement. With regard to the index admission, MLLA was the most expensive due to longer hospital stay (MLLA £13,320; 95% CI, £8986-£18,616 vs BS £8714; 95% CI, £6097-£11,973 vs BET £4813; 95% CI, £3529-£6097; P < .001, Kruskal-Wallis). The total cost of the index admission and in-hospital care over the following 12 months remained least for BET (MLLA £26,327; 95% CI, £17,653-£30,458 vs BS £20,401; 95% CI, £12,071-£23,926 vs BET £12,298; 95% CI, £6961-£15,439; P < .001, Kruskal-Wallis).

Conclusions:
Over a 12-month time horizon, MLLA and IP BS are more expensive than IP BET in terms of procedural HR costs and total in-hospital costs. These economic data, together with quality of life data from BASIL-2, will inform the calculation of incremental cost-effectiveness ratios for different CLTI management strategies within the BASIL-2 cost-utility analysis.

Item Type: Journal Article
Subjects: R Medicine > RB Pathology
R Medicine > RD Surgery
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Ischemia, Ischemia -- Treatment -- Cost effectiveness , Amputation -- Cost effectiveness
Journal or Publication Title: Journal of Vascular Surgery
Publisher: Elsevier B.V.
ISSN: 0741-5214
Official Date: 1 January 2021
Dates:
DateEvent
1 January 2021Published
3 September 2021Available
14 June 2021Accepted
Volume: 75
Number: 1
Page Range: pp. 195-204
DOI: 10.1016/j.jvs.2021.07.232
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
Date of first compliant deposit: 1 October 2021
Date of first compliant Open Access: 3 September 2022
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIEDNational Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
UNSPECIFIEDHealth Technology Assessment programmehttp://dx.doi.org/10.13039/501100000664

Request changes or add full text files to a record

Repository staff actions (login required)

View Item View Item

Downloads

Downloads per month over past year

View more statistics

twitter

Email us: wrap@warwick.ac.uk
Contact Details
About Us