Acute abdominal aortic aneurysms: Cost analysis of endovascular repair and open surgery in hemodynamically stable patients with 1-year follow-up

Purpose: To retrospectively assess the in-hospital and 1-year follow-up costs of endovascular aneurysm repair and conventional open surgery in patients with acute infrarenal abdominal aortic aneurysm ( AAA) by using a resource-use approach. Materials and Methods: Institutional Review Board approval was obtained, and informed consent was waived. In-hospital costs for all consecutive patients ( 61 men, six women; mean age, 72.0 years) who underwent endovascular repair ( n = 32) or open surgery ( n = 35) for acute infrarenal AAA from January 1, 2001, to December 31, 2004, were assessed by using a resource-use approach. Patients who did not undergo computed tomography before the procedure were excluded from analysis. One-year follow-up costs were complete for 30 patients who underwent endovascular repair and for 34 patients who underwent open surgery. Costs were assessed from a health care perspective. Mean costs were calculated for each treatment group and were compared by using the Mann-Whitney U test ( alpha = .05). The influence of clinical variables on the total in-hospital cost was investigated by using univariate and multivariate analyses. Costs were expressed in euros for the year 2003. Results: Sex, age, and comorbidity did not differ between treatment groups ( P > .05). The mean total in-hospital costs were lower for patients who underwent endovascular repair than for those who underwent open surgery ( euro20 767 vs euro35 470, respectively; P = .004). The total costs, including those for 1-year follow-up, were euro23 588 for patients who underwent endovascular repair and euro36 448 for those who underwent open surgery ( P = .05). The results of multivariate analysis indicated that complications had a significant influence on total in-hospital cost; patients who had complications incurred total in-hospital costs that were 2.27 times higher than those for patients who had no complications. Conclusion: Total in-hospital costs and total overall costs, which included 1-year follow-up costs, were lower in patients with acute AAA who underwent endovascular repair than in those who underwent open surgery.