Direct And Total Costs Of Robotic-assisted Vs Conventional Full Sternotomy Coronary Artery Bypass Grafting
Aleksander Dokollari, Serge Sicouri, Basel Ramlawi, Leila Hosseinian, Farah Mahmud, Francis Sutter, Gianluca Torregrossa.
Lankenau Medical Center, Wynnewood, PA, USA.
BACKGROUND: There is a common belief in the medical community that robotic-assisted coronary artery bypass grafting (CABG) has higher hospital costs compared to conventional sternotomy CABG. This study analyze direct and total hospital costs after robotic-assisted CABG versus conventional sternotomy. METHODS: This is a propensity-score analysis of consecutive patients that had robotic-assisted and conventional full sternotomy CABG between January 2018 to December 2021 at Lankenau Medical Center. These are two different populations and the propensity matching was performed only for the cost analysis purpose. RESULTS: After matching, a total of 1,173 patients were included in the analysis, with 582 patients in the conventional sternotomy group and 591 in the robotic-assisted group. Results are reported as cost/$1000. On average, robotic-assisted CABG group has a lower mean direct and total cost compared to conventional sternotomy CABG group ($25.3 (SD 11.1) vs $33.4 (SD 21.2) direct cost; $43.2(SD 19.8) vs $58.2 (SD 39) total cost, p <.0001 respectively). However, the adjusted mean costs did not differ between the two groups (p=0.9 and p=0.787 for direct and total costs). In the subgroup analyses (conventional sternotomy/robotic non hybrid/robotic hybrid), sternotomy and non-hybrid robotic differed in direct and total mean costs but not after statistical adjustment. All other subgroup comparisons were not significantly different. When we added length of stay (LOS) as an interaction between the surgery groups (sternotomy vs robotic), robotic-assisted CABG direct and total costs decreased as LOS increased compared to conventional sternotomy (β -0.66 (95% CI -1.2, -0.1) p= 0.023 [direct cost], β -1.3 (95% CI -2.2, -0.3) p=0.11 [total cost]).Conclusion: Robotic-assisted CABG has similar hospital costs compared to conventional sternotomy CABG.
Back to 2023 ePosters