Predictors of costs from the hospital perspective of primary pulmonary embolism

Motte, Serge; Mélot, Christian; Pierdomenico, Lionel Di; Martins, Dimitri; Leclercq, Pol; Pirson, Michael

doi:10.1183/13993003.00281-2015

Cited by 14 publications

(8 citation statements)

References 21 publications

(28 reference statements)

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“…The characteristics of elderly patients lead to longer stays. Lower costs for oldest old patients (85+) have already been confirmed as regards primary pulmonary embolism in a previous study (Motte et al, 2016).…”

Section: Complex Medical Profile With Extreme Severity Of Illness Mortality Risk and Many Comorbiditiessupporting

confidence: 58%

Profile of hospitalised elderly patients in Belgium—Analysis of factors affecting hospital costs

Foor

Senterre

Leclercq

et al. 2020

The Journal of the Economics of Ageing

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The objectives of this research are (i) to describe the medicoadministrative profiles of inpatients aged 65 and over and (ii) to determine the main hospitalisation-related diseases in order (iii) to assess and identify predictors influencing hospital costs and lengths of stay thanks to data collected in hospital administrative databases. Methods: The study is based on 45,469 hospital stays of inpatients aged 65 and over, with data collected among ten Belgian general hospitals in 2014. We conduct a linear regression in order to isolate factors influencing hospital costs and length of stay. Results: The mean length of stay (SD) for older patients (65+) is 11 days (18.17) and the mean hospitalisation cost (SD) €6706 (9422). The main predictor of hospital costs is the length of stay. A linear regression (n = 41,348, R 2 = 0.4520) reveals that predictors of a longer LOS for hospitalised older patients are: to be a male, to come from another hospital, to be sent to hospital by a general practitioner, to be admitted through the emergency department, to undergo a surgical procedure, to suffer from a major or extreme SOI or run a major or extreme mortality risk, to have a high score on the Charlson Comorbidity Index (CCI), to stay in an ICU, to belong to older age categories (85+), and to be institutionalised after discharge. Conclusion: Advanced age is by itself only a weak predictor of hospital cost, but it is a good predictor of a longer hospital stay.

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Section: Complex Medical Profile With Extreme Severity Of Illness Mortality Risk and Many Comorbiditiessupporting

confidence: 58%

Profile of hospitalised elderly patients in Belgium—Analysis of factors affecting hospital costs

Foor

Senterre

Leclercq

et al. 2020

The Journal of the Economics of Ageing

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“…In van Boven JF et al study [41], they found that allergic rhinitis, anxiety, osteoporosis and gastroesophageal reflux disease are more related to the ACOS cohort than the pure COPD cohort, while ischemia heart disease (IHD) and chronic kidney disease were less associated. Regarding the impact on hospitalization risk in this previous study, the comorbidities such as lung cancer [9] and cor pulmonale [8] had relatively the strongest association with 1-year all-cause hospitalization risk in the ACOS cohort [41]. Meanwhile, these two factors [8,9] are associated with the PE also [42].…”

Section: Discussionmentioning

confidence: 98%

“…Regarding the impact on hospitalization risk in this previous study, the comorbidities such as lung cancer [9] and cor pulmonale [8] had relatively the strongest association with 1-year all-cause hospitalization risk in the ACOS cohort [41]. Meanwhile, these two factors [8,9] are associated with the PE also [42]. In their study did not include PE, and that would warrant further investigation, likewise for the differences between risk for PE in ACOS cohort and pure asthma cohort alone.…”

Section: Discussionmentioning

confidence: 99%

“…High mortality is associated with a delayed diagnosis of acute PE [3]. Recent studies have indicated that the predisposing factors for PE include numerous underlying diseases such as obstructive airway disease (causing asthma [4] and chronic obstructive pulmonary disease [COPD] [5]), atherosclerosis [6] (causing hypertension, diabetes [7], and stroke), heart failure [8] and cancer [9]. …”

Section: Introductionmentioning

confidence: 99%

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Asthma–Chronic Obstructive Pulmonary Disease Overlap Syndrome Associated with Risk of Pulmonary Embolism

2016

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PurposeWe conducted a cohort study to clarify this relationship between asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) and pulmonary embolism (PE).MethodsFrom the National Health Insurance Research Database of Taiwan, we identified patients who had a diagnosis of asthma and a diagnosis of COPD (defined as ACOS) and concurrent treatment between January 1999 and December 2009 (ACOS cohort: n = 14,150; non-ACOS cohort: n = 55,876). Cox proportional hazards regression analysis was performed to determine the adjusted hazard ratios (aHRs) for PE of the ACOS cohort compared with the non-ACOS cohort.ResultsComparing the ACOS cohort with the non-ACOS cohort, the aHR of PE was 2.08 (95% confidence intervals [CIs]: 1.56–2.76). The risk of PE was higher in ACOS cohort than non-ACOS cohort, regardless of age, sex, comorbidity, inhaled corticosteroids (ICSs) and oral steroids (OSs) used. For ages ranging from 20 to 65 years, the aHR of PE was 2.53 (95% CI: 1.44–4.44) in the ACOS cohort. ACOS patients using ICSs (aHR: 1.97, 95% CI: 1.29–3.01) or OSs (aHR: 1.97, 95% CI: 1.46–2.65), the risk of PE was higher than in the non-ACOS cohort. The risk of PE increased with the number of outpatient visits and hospitalizations necessitated, ranging from 2.32 (95% CI: 1.54–3.52) in patients having 3–9 visits to 4.20 (95% CI: 2.74–6.44) for those having >9 visits.ConclusionsACOS is associated with increased risk of PE, particularly patients with a high frequency of AE—even in young adults or people without comorbidities.

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“…The literature shows that LOS following PE ranges from 5 to 11 days. [13][14][15][16][17] If a PERT participates in the care of a patient for the duration of the hospitalization (which was not true for the WCMC PERT), then it can give discharge recommendations and potentially impact LOS. However, a PERT may also impact LOS based on how it manages severe PE.…”

Section: Discussionmentioning

confidence: 99%

A pulmonary embolism response team’s initial 20 month experience treating 87 patients with submassive and massive pulmonary embolism

et al. 2017

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Pulmonary Embolism Response Teams (PERTs) have emerged to provide rapid multidisciplinary assessment and treatment of PE patients. However, descriptive institutional experience and preliminary outcomes data from such teams are sparse. PERT activations were identified through a retrospective review. Only confirmed submassive or massive PEs were included in the data analysis. In addition to baseline variables, the therapeutic intervention, length of stay (LOS), in-hospital mortality, and bleeding rate/severity were recorded. A total of 124 PERT activations occurred over 20 months: 43 in the first 10 months and 81 in the next 10. A total of 87 submassive (90.8%) and massive (9.2%) PE patients were included. The median age was 65 (51-75 IQR) years. Catheter-directed thrombolysis (CDT) was administered to 25 patients, systemic thrombolysis (ST) to six, and anticoagulation alone (AC) to 54. The median ICU stay and overall LOS were 6 (3-10 IQR) and 7 (4-14 IQR) days, respectively, with no association with any variables except a brain natriuretic peptide (BNP) >100 pg/mL ( p=0.008 ICU LOS; p=0.047 overall LOS). Twelve patients (13.7%) died in the hospital, nine of whom had metastatic or brain cancer, with a median overall LOS of 13 (11-17 IQR) days. There were five major bleeds: one in the CDT group, one in the ST group, and three in the AC group. Overall, (1) PERT activations increased after the first 10 months; (2) BNP >100 pg/mL was associated with a longer LOS; (3) rates of mortality and bleeding did not correlate with treatment; and (4) the majority of in-hospital deaths occurred in patients with advanced cancer.

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Predictors of costs from the hospital perspective of primary pulmonary embolism

Abstract: The objective of this study was to estimate the total hospital cost per patient admitted through the emergency department with a primary diagnosis of pulmonary embolism (PE), and to identify the main components and predictors of costs.

Cited by 14 publications

References 21 publications

Profile of hospitalised elderly patients in Belgium—Analysis of factors affecting hospital costs

Profile of hospitalised elderly patients in Belgium—Analysis of factors affecting hospital costs

Asthma–Chronic Obstructive Pulmonary Disease Overlap Syndrome Associated with Risk of Pulmonary Embolism

A pulmonary embolism response team’s initial 20 month experience treating 87 patients with submassive and massive pulmonary embolism

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