Cost of Bleeding in XXXX and Complex Cardiac Surgery.

@entity1 @entity130 @entity548
PURPOSE: @entity130 and complex cardiac surgery are associated with a high risk of @entity548 complications. The difference in costs between @entity1 who require @entity548 control measures and those who do not is poorly understood. Our goal was to assess the cost of care and outcomes for @entity1 in these settings. METHODS: @entity1 >18 years of age, who were discharged between January 2010 and December 2012, were retrospectively identified in the Premier Hospital Database based on International Classification of Disease, Ninth Revision codes. These @entity1 were categorized as having received blood products (" @entity548 @entity1 ") or not ("nonbleeding @entity1 "). @entity1 with costs and length of stay (LOS) of zero were excluded. Differences in treatment costs and outcomes were assessed using univariate analysis and multivariate modeling. FINDINGS: Bleeding @entity130 @entity1 (n = 8800) had a 150% higher total cost of care (P < 0.001; 146% after excluding costs of agents used for @entity548 control, P < 0.001), an 81.3% longer hospital LOS (P < 0.001), and a 65.2% longer intensive care unit (ICU) LOS (P < 0.001) than nonbleeding @entity1 (n = 53,727). Bleeding complex cardiac surgery @entity1 (n = 82,832) had a 133.2% higher total cost of care (P < 0.001; 128.7% after excluding costs of agents used for @entity548 control, P < 0.001), a 155.6% longer hospital LOS (P < 0.001), and an 89.3% longer ICU LOS (P < 0.001) than nonbleeding @entity1 (n = 380,902). IMPLICATIONS: @entity130 and cardiac surgery @entity1 who experienced @entity548 and received allogeneic blood product transfusions had significantly worse outcomes, including longer LOS, greater inpatient mortality, and higher costs of care (even when excluding costs of agents used for @entity548 control) than those who did not.
