Evidence map›Paper›PMID 38688237›Full record

ArticleThe Journal of surgical research2024

Early Financial Outcomes of Physician Modified Endograft Programs Are Dictated by Device Cost.

Baqir J Kedwai, Joshua T Geiger, Daniel J Lehane, Karina A Newhall, Grayson S Pitcher, Michael C Stoner, Doran S Mix

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of surgical research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
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

7 authors.

Baqir J KedwaiDivision of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York.
Joshua T GeigerDivision of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York.
Daniel J LehaneDivision of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York.
Karina A NewhallDivision of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York.
Grayson S PitcherDivision of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York.
Michael C StonerDivision of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York.
Doran S MixDivision of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York. Electronic address: dmix@urmc.rochester.edu.

Funding

NRSA Training CoreTL1TR002000 · NCATS · UNIVERSITY OF ROCHESTER · PI THAKAR, JUILEE, VAN WIJNGAARDEN, EDWIN · 2016 to 2024
$4.1M
NCATS NIH HHS TL1 TR002000
6 · The paper itself

Abstract

introductionPhysician-modified endografts (PMEGs) have been used for repair of thoracoabdominal aortic aneurysms (TAAAs) for 2 decades with good outcomes but limited financial data. This study compared the financial and clinical outcomes of PMEGs to the Cook Zenith-Fenestrated (ZFEN) graft and open surgical repair (OSR).

methodsA retrospective review of financial and clinical data was performed for all patients who underwent endovascular or OSR of juxtarenal aortic aneurysms and TAAAs from January 2018 to December 2022 at an academic medical center. Clinical presentation, demographics, operative details, and outcomes were reviewed. Financial data was obtained through the institution's finance department. The primary end point was contribution margin (CM).

resultsThirty patients met inclusion criteria, consisting of twelve PMEG, seven ZFEN, and eleven open repairs. PMEG repairs had a total CM of -$110,000 compared to $18,000 for ZFEN and $290,000 for OSR. Aortic and branch artery implants were major cost-drivers for endovascular procedures. Extent II TAAA repairs were the costliest PMEG procedure, with a total device cost of $59,000 per case. PMEG repairs had 30-d and 1-y mortality rates of 8.3% which was not significantly different from ZFEN (0.0%, P = 0.46; 0.0%, P = 0.46) or OSR (9.1%, P = 0.95; 18%, P = 0.51). Average intensive care unit and hospital stay after PMEG repairs were comparable to ZFEN and shorter than OSR.

conclusionsOur study suggests that PMEG repairs yield a negative CM. To make these cases financially viable for hospital systems, device costs will need to be reduced or reimbursement rates increased by approximately $8800.

Indexed as

Blood Vessel ProsthesisBlood Vessel Prosthesis ImplantationEndovascular ProceduresAgedAged, 80 and overAortic Aneurysm, AbdominalAortic Aneurysm, ThoracicFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeAneurysmAortaCostEndograftEndovascular

Identifiers

PMID38688237
PMCPMC11189729

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Registered trials

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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.