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      Incremental cost and length of stay associated with postprocedure delirium in transcatheter and surgical aortic valve replacement patients in the United States

      1 , 2 , 3 , 4 , 3

      Catheterization and Cardiovascular Interventions

      Wiley

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          Most cited references 14

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          One-year health care costs associated with delirium in the elderly population.

          While delirium has been increasingly recognized as a serious and potentially preventable condition, its long-term implications are not well understood. This study determined the total 1-year health care costs associated with delirium. Hospitalized patients aged 70 years and older who participated in a previous controlled clinical trial of a delirium prevention intervention at an academic medical center between 1995 and 1998 were followed up for 1 year after discharge. Total inflation-adjusted health care costs, calculated as either reimbursed amounts or hospital charges converted to costs, were computed by means of data from Medicare administrative files, hospital billing records, and the Connecticut Long-term Care Registry. Regression models were used to determine costs associated with delirium after adjusting for patient sociodemographic and clinical characteristics. During the index hospitalization, 109 patients (13.0%) developed delirium while 732 did not. Patients with delirium had significantly higher unadjusted health care costs and survived fewer days. After adjusting for pertinent demographic and clinical characteristics, average costs per day survived among patients with delirium were more than 2(1/2) times the costs among patients without delirium. Total cost estimates attributable to delirium ranged from $16 303 to $64 421 per patient, implying that the national burden of delirium on the health care system ranges from $38 billion to $152 billion each year. The economic impact of delirium is substantial, rivaling the health care costs of falls and diabetes mellitus. These results highlight the need for increased efforts to mitigate this clinically significant and costly disorder.
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            Frailty in Older Adults Undergoing Aortic Valve Replacement

            Frailty is a geriatric syndrome that diminishes the potential for functional recovery after a transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) procedure; however, its integration in clinical practice has been limited by a lack of consensus on how to measure it.
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              Health economic implications of perioperative delirium in older patients after surgery for a fragility hip fracture.

              Patients who experience a fragility hip fracture are at high risk for perioperative delirium. The purpose of the present study was to evaluate the impact, from a hospital perspective, of perioperative delirium on the length of the hospital stay and episode-of-care costs for elderly patients who underwent surgical treatment of a fragility hip fracture.
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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                Catheterization and Cardiovascular Interventions
                Catheter Cardiovasc Interv
                Wiley
                1522-1946
                1522-726X
                April 25 2019
                May 2019
                December 14 2018
                May 2019
                : 93
                : 6
                : 1132-1136
                Affiliations
                [1 ]Interventional Cardiology Service, Cardiovascular CenterUniversity of Montreal Hospital Center (CHUM) Montreal Quebec Canada
                [2 ]Carrefour d'innovation et d'évaluation en santé (CIÉS)Research Center of the University of Montreal Hospital Center (CRCHUM) Montreal Quebec Canada
                [3 ]Edwards Lifesciences Irvine California
                [4 ]Division of Cardiology, Department of MedicineColumbia University Medical Center New York New York
                Article
                10.1002/ccd.28014
                © 2019

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