Moucharite Marilyn A, Zhang Jianying, Giffin Robert
Healthcare Economics Outcomes Research, Medtronic, Mansfield, MA, USA.
Clinicoecon Outcomes Res. 2021 Apr 1;13:227-239. doi: 10.2147/CEOR.S304037. eCollection 2021.
Establishing good mechanical ventilation is a critical component and prerequisite to a wide range of surgical and medical interventions. Yet difficulties in intubating patients, and a variety of associated complications, are well documented. The economic burden resulting from difficult intubation (DI), however, is not well understood. The current study examines the economic burden of documented DI during inpatient surgical admissions and explores factors that are associated with DI.
Using data from the Premier Healthcare Database, adult patients with inpatient surgical admissions between January 1, 2016 and December 31, 2018 were selected. International Classification of Diseases, Tenth Edition, Clinical Modification (ICD-10-CM) diagnosis codes were used to classify the patients into matched cohorts of DI and non-DI patients.
Patients in the DI group have mean inpatient costs and intensive care unit (ICU) costs that are substantially higher than patients without difficult intubations ($14,468 and $4,029 higher, respectively). Mean hospital length of stay and ICU length of stay were 3.8 days and 2.0 days longer, respectively (all p<0.0001, except ICU cost p=0.0001) in the DI group. Obesity, other chronic conditions, and larger hospital size were significantly associated with DI.
DI is associated with higher average cost and longer average length of stay.
建立良好的机械通气是广泛的外科和医学干预的关键组成部分和前提条件。然而，患者插管困难及各种相关并发症已有充分记录。然而，困难插管（DI）所导致的经济负担尚未得到充分认识。本研究调查了住院手术患者中记录在案的DI的经济负担，并探讨了与DI相关的因素。
利用Premier医疗数据库的数据，选取了2016年1月1日至2018年12月31日期间住院手术的成年患者。使用国际疾病分类第十版临床修订本（ICD-10-CM）诊断代码将患者分为DI组和非DI组的匹配队列。
DI组患者的平均住院费用和重症监护病房（ICU）费用显著高于无插管困难的患者（分别高出14468美元和4029美元）。DI组的平均住院天数和ICU住院天数分别长3.8天和2.0天（除ICU费用p = 0.0001外，所有p<0.0001）。肥胖、其他慢性疾病和更大的医院规模与DI显著相关。
DI与更高的平均费用和更长的平均住院时间相关。
