Evidence map›Paper›PMID 34261982›Full record

ArticleJournal of the Chinese Medical Association : JCMA2021

Endovascular aortic repair is a cost-effective option for in-hospital patients with abdominal aortic aneurysm.

Chia-Wen Shih, Shung-Tai Ho, Hao-Ai Shui, Chi-Tun Tang, Chun-Che Shih, Tzeng-Ji Chen, Kuan-Chia Lin, Chun-Yu Liang, Kwua-Yun Wang

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the Chinese Medical Association : JCMA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Chia-Wen ShihGraduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.
Shung-Tai HoGraduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.
Hao-Ai ShuiGraduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.
Chi-Tun TangDepartment of Neurological Surgery, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan, ROC.
Chun-Che ShihTaipei Heart Institute, Taipei Medical University, Division of Cardiovascular Surgery, Taipei, Taiwan, ROC.
Tzeng-Ji ChenSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Kuan-Chia LinInstitute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Chun-Yu LiangSchool of Nursing, National Defense Medical Center, Taipei, Taiwan, ROC.
Kwua-Yun WangGraduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.
National Defense Medical Center · TWNational Yang Ming Chiao Tung University · TWTaipei Veterans General Hospital · TWTri-Service General Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo investigate the cost-effectiveness of endovascular aortic repair (EVAR) versus open aortic repair (OAR) for abdominal aortic aneurysm (AAA) using incremental costs per decreased in-hospital mortality rate gained through our patients' cohort.

methodsMedical records and healthcare costs of patients with AAA hospitalized between 2010 and 2015 were extracted from the National Health Insurance Research Database (NHIRD) of Taiwan. Multiple regression analysis was applied to adjust for confounding factors and to compare the differences in postoperative clinical outcomes between patients who received EVAR and OAR. The incremental cost-effectiveness ratio (ICER) of EVAR was determined based on the healthcare cost obtained from the analyzed data.

resultsA total of 2803 AAA patients were identified (n = 559 with ruptured AAA and n = 2244 unruptured AAA). Patients with ruptured AAA who underwent EVAR compared with OAR patients had shorter hospital and intensive care unit (ICU) stays (all p < 0.05). For patients with unruptured AAA, those who received EVAR compared with OAR, the adjusted odds ratio (aOR) of postoperative complications and in-hospital mortality were 0.371 and 0.447 (all p < 0.05). The total direct surgical costs and medical expenses during hospitalization in all AAA patients were higher for the EVAR group; however, ICER was <1 per capita gross domestic product. Stratification by age groups further suggested that ICER for patients with unruptured AAA who received EVAR, compared with OAR, decreased with age.

conclusionTotal direct medical costs were higher for AAA patients receiving EVAR regardless of rupture status; however, the cost is offset by lower odds of postoperative complications and in-hospital mortality. The observed decrease in ICER with age and EVAR use warrants further analysis. Our findings further validate the use of EVAR over OAR. These results provides supporting evidence for physicians and patients with AAA to inform shared decision making regarding endovascular or OAR options.

Indexed as

Hospital MortalityAgedAortic Aneurysm, AbdominalCost-Benefit AnalysisEndovascular ProceduresFemaleHumansMaleMiddle AgedRetrospective StudiesTaiwan

Identifiers

PMID34261982
PMCPMC12966024
OpenAlexW3179799970

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.