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DOI: 10.1055/s-0029-1191618
EuroSCORE is of predictive value to estimate prospective complication-related costs in cardiac surgery
Objectives: The aim of the study was to evaluate if the Euroscore can be used to predict the risk of additional financial burden associated with specific complications following cardiac surgery.
Methods: Data on 120 consecutive patients undergoing isolated (57.5%) or combined coronary artery bypass grafting (21.6%), isolated valve surgery (16.7%) and thoracic aortic surgery (1.7%) from July 2007 to August 2007 were prospectively analysed. Patients were subdivided into four risk groups according to EuroSCORE. Multivariate analysis was performed to identify specific complications, which are independently correlated with Euroscore. Concerning these complications, the associated financial sequelae, excluding fix costs and operation costs, were calculated for each risk group and compared by U-Test.
Results: Preoperative Euroscore showed good correlation with acute renal failure (p<0.001) and dialysis (p=0.003), total ICU stay >48h (p<0.001), usage of IABP (p<0.001), and increased use of banked blood. Mean costs were 1175€ for EuroSCORE 1–3, 2078€ for EuroSCORE 4–5, 2421€ for EuroSCORE 6–8 and 5883€ for EuroSCORE >9. There was a significant difference between patients with EuroSCORE 4–5 and 6–8 (p=0.007) and between patients with EuroSCORE 6–8 and=/>9 (p=0.003).
Conclusion: EuroSCORE can not only be used for predicting 30-days-mortality but also for cost calculation using its prognostic value for prolonged ICU stay and major complications. These complication-related costs are only partially reimbursed by extra payment additionally to G-DRG-case flat-rates.