Lage M J, Barber B L, McCollam P L, Bala M, Scherer J
Department of Economics, Miami University, Oxford, Ohio, USA.
Catheter Cardiovasc Interv. 2001 Mar;52(3):298-305. doi: 10.1002/ccd.1069.
The purpose of this retrospective study was to examine in a naturalistic setting the effect of abciximab versus tirofiban on hospital length of stay for patients undergoing percutaneous coronary intervention (PCI). Retrospective data were obtained from HCIASach's Clinical Pathways Database on 5,560 PCI patients who were administered either abciximab or tirofiban. Multivariate analysis was used to control for a wide range of factors (GPIIb/IIIa selection, patient demographics, insurance provider, health conditions, admission information, and hospital characteristics) that may influence hospital length of stay. Estimation was conducted via a two-stage sample selection model. After controlling for high-risk indications and sources of selection bias, results indicate that receipt of abciximab was associated with significantly shorter lengths of hospital stays compared to tirofiban (1.01 fewer days; p < 0.001). In a subgroup analysis of patients having an acute myocardial infarction (AMI; n = 2,593), receipt of abciximab was also found to be associated with significantly shorter hospital stays compared to tirofiban (0.60 fewer days; p < 0.001). Results of this study indicate that patients who are administered abciximab versus tirofiban have significantly shorter hospital stays. This reduction in length of stay may imply potential cost offsets for PCI patients who receive abciximab.
这项回顾性研究的目的是在自然环境中检验阿昔单抗与替罗非班对接受经皮冠状动脉介入治疗（PCI）患者住院时间的影响。回顾性数据取自HCIASach临床路径数据库中5560例接受阿昔单抗或替罗非班治疗的PCI患者。采用多变量分析来控制一系列可能影响住院时间的因素（糖蛋白IIb/IIIa选择、患者人口统计学特征、保险提供商、健康状况、入院信息和医院特征）。通过两阶段样本选择模型进行估计。在控制了高风险指征和选择偏倚来源后，结果表明，与替罗非班相比，接受阿昔单抗治疗的患者住院时间显著缩短（少1.01天；p<0.001）。在急性心肌梗死（AMI；n=2593）患者的亚组分析中，与替罗非班相比，接受阿昔单抗治疗的患者住院时间也显著缩短（少0.60天；p<0.001）。本研究结果表明，接受阿昔单抗治疗的患者与接受替罗非班治疗的患者相比，住院时间显著缩短。住院时间的缩短可能意味着接受阿昔单抗治疗的PCI患者潜在的成本抵消。
