Burudpakdee Chakkarin, Near Aimee M, Huang Huan, Coppolo Dominic, Kushnarev Vladimir, Suggett Jason
IQVIA, Fairfax, VA, USA.
Monaghan Medical Corporation, Syracuse, NY, USA.
Pulm Ther. 2018 Jun;4(1):87-101. doi: 10.1007/s41030-018-0055-9. Epub 2018 May 16.
The aim of this real-world study was to measure the benefit of the Aerobika oscillating positive expiratory pressure (OPEP) device when added to standard of care (defined as incentive spirometry [IS]) for post-operative patients.
Adults aged ≥ 18 years who were hospitalized for cardiac, thoracic or upper abdominal surgery between 1 September 2013 and 30 April 2017 were identified from IQVIA's Hospital Charge Detail Master (CDM) database; the index date was the date of the first hospitalization for surgery. The control cohort (IS) included patients who had ≥ 1 CDM record within 12 months prior to the index date and ≥ 1 record after discharge, evidence of IS use during index hospitalization and no evidence of use of a PEP or OPEP device at any time during the study period. The Aerobika OPEP cohort was selected in a similar manner, except that patients were required to have evidence of Aerobika OPEP use during the index hospitalization. Aerobika OPEP patients were 1:1 matched to IS patients using propensity score (PS) matching. Hospital readmissions and costs were measured at 30 days post-discharge from the index hospitalization.
After PS matching, 144 patients were included in each cohort. At 30 days post-discharge, compared to the control (IS) cohort there were significantly fewer patients in the Aerobika OPEP cohort with ≥ 1 all-cause re-hospitalizations (13.9 vs. 22.9%; p = 0.042). The patients in the Aerobika OPEP cohort also had a shorter mean length of stay (± standard deviation) (1.25 ± 4.04 vs. 2.60 ± 8.24 days; p = 0.047) and lower total unadjusted mean all-cause cost per patient ($3670 ± $13,894 vs. $13,775 ± $84,238; p = 0.057). Adjusted analyses suggested that hospitalization costs were 80% lower for the Aerobika OPEP cohort versus the IS cohort (p = 0.001).
Our results suggest that the addition of the Aerobika OPEP device to standard of care (IS) is beneficial in the post-operative setting.
Trudell Medical International.
本真实世界研究的目的是评估在标准护理（定义为激励式肺量计[IS]）基础上，为术后患者添加Aerobika振荡呼气末正压（OPEP）装置的益处。
从IQVIA的医院收费明细主数据库（CDM）中识别出2013年9月1日至2017年4月30日期间因心脏、胸科或上腹部手术住院的年龄≥18岁的成年人；索引日期为首次手术住院日期。对照组（IS）包括在索引日期前12个月内有≥1条CDM记录且出院后有≥1条记录、索引住院期间有IS使用证据且在研究期间任何时候均无PEP或OPEP装置使用证据的患者。Aerobika OPEP组以类似方式选择，不同之处在于患者在索引住院期间需有Aerobika OPEP使用证据。使用倾向评分（PS）匹配将Aerobika OPEP患者与IS患者进行1:1匹配。在索引住院出院后30天测量医院再入院情况和费用。
PS匹配后，每组纳入144例患者。出院后30天，与对照组（IS）相比，Aerobika OPEP组中全因再住院≥1次的患者明显更少（13.9%对22.9%；p = 0.042）。Aerobika OPEP组患者的平均住院时间（±标准差）也更短（1.25±4.04天对2.60±8.24天；p = 0.047），且每位患者的全因总未调整平均费用更低（3670美元±13894美元对13775美元±84238美元；p = 0.057）。调整分析表明，Aerobika OPEP组的住院费用比IS组低80%（p = 0.001）。
我们的结果表明，在标准护理（IS）基础上添加Aerobika OPEP装置在术后环境中是有益的。
Trudell Medical International。
