The High Cost of Death Associated with Acute Myocardial Infarctions
Start Date
29-4-2022 3:45 PM
Location
Alter Hall Poster Session 2 - 2nd floor
Abstract
Objectives: The objective of this study was to describe the differences in costs and length of stay (LOS) among patients with acute myocardial infarction (AMI) who die in the hospital compared to those who survive in the United States (US).
Methods: The Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) in this study was used to statistically analyze outcomes, costs, and LOS. The NIS is the largest publicly-available all-payer database in the US and includes statistical weights to allow the generation of national estimates of direct medical resource use, access to healthcare, charges, quality, and outcomes. All admitted patients in 2019 with a principal diagnosis of AMI as defined by International Classification of Diseases (ICD-10-CM) codes were included in this analysis. Patient visits were stratified into cohorts by death or discharged alive. Summary statistics were calculated using mean and standard deviation for continuous variables and counts and percentages for categorical variables. Univariate tests determined if there were statistical differences between the died and alive cohorts and outcomes variables, doing so with parametric and nonparametric testing depending on the appropriateness of the variable.
Results: There were 117,440 total hospital visits in 2019 with a principal diagnosis of AMI. Of these, 4,946 (4.21%) died during the hospitalization. The average age was 67 and 74 (p value <0.001) for those that were discharged alive and died, respectively. Females comprised of 36.95% and 41.06% of the alive and died cohorts (p value <0.001). Patients who died were more likely to have cardiogenic shock (7.70%) compared to those who were discharged alive (3.81%; p value <0.001). Whereas, patients who were discharged alive were more likely to be admitted for an elective visit (3.89%) compared to those who died (3.32%; p value 0.022). The total cost of the hospital visit was $23,252 for those discharged alive and $38,336 for those who died (p value <0.001). The LOS was 4.36 days for those discharged alive and 5.25 for those who died (p value <0.001).
Conclusion: Patients admitted with a principal diagnosis of AMI and died cost $15,085 (64.88%) more than those discharged alive. Further, the LOS was 20% (0.89 days) longer for those who died during the hospital visit. Further multivariable analysis is necessary to determine if these significant differences remain after adjusting for differences in patient characteristics.
The High Cost of Death Associated with Acute Myocardial Infarctions
Alter Hall Poster Session 2 - 2nd floor
Objectives: The objective of this study was to describe the differences in costs and length of stay (LOS) among patients with acute myocardial infarction (AMI) who die in the hospital compared to those who survive in the United States (US).
Methods: The Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) in this study was used to statistically analyze outcomes, costs, and LOS. The NIS is the largest publicly-available all-payer database in the US and includes statistical weights to allow the generation of national estimates of direct medical resource use, access to healthcare, charges, quality, and outcomes. All admitted patients in 2019 with a principal diagnosis of AMI as defined by International Classification of Diseases (ICD-10-CM) codes were included in this analysis. Patient visits were stratified into cohorts by death or discharged alive. Summary statistics were calculated using mean and standard deviation for continuous variables and counts and percentages for categorical variables. Univariate tests determined if there were statistical differences between the died and alive cohorts and outcomes variables, doing so with parametric and nonparametric testing depending on the appropriateness of the variable.
Results: There were 117,440 total hospital visits in 2019 with a principal diagnosis of AMI. Of these, 4,946 (4.21%) died during the hospitalization. The average age was 67 and 74 (p value <0.001) for those that were discharged alive and died, respectively. Females comprised of 36.95% and 41.06% of the alive and died cohorts (p value <0.001). Patients who died were more likely to have cardiogenic shock (7.70%) compared to those who were discharged alive (3.81%; p value <0.001). Whereas, patients who were discharged alive were more likely to be admitted for an elective visit (3.89%) compared to those who died (3.32%; p value 0.022). The total cost of the hospital visit was $23,252 for those discharged alive and $38,336 for those who died (p value <0.001). The LOS was 4.36 days for those discharged alive and 5.25 for those who died (p value <0.001).
Conclusion: Patients admitted with a principal diagnosis of AMI and died cost $15,085 (64.88%) more than those discharged alive. Further, the LOS was 20% (0.89 days) longer for those who died during the hospital visit. Further multivariable analysis is necessary to determine if these significant differences remain after adjusting for differences in patient characteristics.
