Economic assessment of traditional surgical intervention versus use of a new innovative radiofrequency based surgical system in device replacements
Intra-operative complications like mechanical damages to the leads, infections and hematomas during generator replacements of implantable pacemakers and defibrillators contribute to additional costs for hospitals. The aim of this study was to evaluate operation room use, costs and budget impact of g...
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| Published in: | PloS one Vol. 13; no. 3; p. e0192587 |
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| Abstract | Intra-operative complications like mechanical damages to the leads, infections and hematomas during generator replacements of implantable pacemakers and defibrillators contribute to additional costs for hospitals. The aim of this study was to evaluate operation room use, costs and budget impact of generator replacements using either a traditional surgical intervention (TSI) with scissors, scalpel and electrocautery vs. a new radiofrequency energy based surgical system, called PEAK PlasmaBladeTM (PPB).
We conducted a retrospective analysis of a population including 508 patients with TSI and 254 patients with PPB who underwent generator replacement at the Kepler University Hospital in Linz or the St. Josef Hospital in Braunau, Austria. The economic analysis included costs of resources used for intra-operative complications (lead damages) and of procedure time for TSI vs. PPB.
Proportion of males, mean age and type of generator replaced were similar between the two groups. Lead damages occurred significantly more frequent with TSI than with PPB (5.3% and 0.4%; p< 0.001) and the procedure time was significantly longer with TSI than with PPB (47.9±24.9 and 34.1±18.1 minutes; p<0.001). Shorter procedure time and a lower rate of lead damages with PPB resulted in per patient cost savings of €81. Based on estimated 2,700 patients annually undergoing generator replacement in Austria, the use of PPB may translate into cost savings of €219,600 and 621 saved operating facility hours.
PPB has the potential to minimize the risk of lead damage with more efficient utilization of the operating room. Along with cost savings and improved quality of care, hospitals may use the saved operating room hours to increase the number of daily surgeries. |
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| AbstractList | Intra-operative complications like mechanical damages to the leads, infections and hematomas during generator replacements of implantable pacemakers and defibrillators contribute to additional costs for hospitals. The aim of this study was to evaluate operation room use, costs and budget impact of generator replacements using either a traditional surgical intervention (TSI) with scissors, scalpel and electrocautery vs. a new radiofrequency energy based surgical system, called PEAK PlasmaBladeTM (PPB).INTRODUCTIONIntra-operative complications like mechanical damages to the leads, infections and hematomas during generator replacements of implantable pacemakers and defibrillators contribute to additional costs for hospitals. The aim of this study was to evaluate operation room use, costs and budget impact of generator replacements using either a traditional surgical intervention (TSI) with scissors, scalpel and electrocautery vs. a new radiofrequency energy based surgical system, called PEAK PlasmaBladeTM (PPB).We conducted a retrospective analysis of a population including 508 patients with TSI and 254 patients with PPB who underwent generator replacement at the Kepler University Hospital in Linz or the St. Josef Hospital in Braunau, Austria. The economic analysis included costs of resources used for intra-operative complications (lead damages) and of procedure time for TSI vs. PPB.MATERIALS AND METHODSWe conducted a retrospective analysis of a population including 508 patients with TSI and 254 patients with PPB who underwent generator replacement at the Kepler University Hospital in Linz or the St. Josef Hospital in Braunau, Austria. The economic analysis included costs of resources used for intra-operative complications (lead damages) and of procedure time for TSI vs. PPB.Proportion of males, mean age and type of generator replaced were similar between the two groups. Lead damages occurred significantly more frequent with TSI than with PPB (5.3% and 0.4%; p< 0.001) and the procedure time was significantly longer with TSI than with PPB (47.9±24.9 and 34.1±18.1 minutes; p<0.001). Shorter procedure time and a lower rate of lead damages with PPB resulted in per patient cost savings of €81. Based on estimated 2,700 patients annually undergoing generator replacement in Austria, the use of PPB may translate into cost savings of €219,600 and 621 saved operating facility hours.RESULTSProportion of males, mean age and type of generator replaced were similar between the two groups. Lead damages occurred significantly more frequent with TSI than with PPB (5.3% and 0.4%; p< 0.001) and the procedure time was significantly longer with TSI than with PPB (47.9±24.9 and 34.1±18.1 minutes; p<0.001). Shorter procedure time and a lower rate of lead damages with PPB resulted in per patient cost savings of €81. Based on estimated 2,700 patients annually undergoing generator replacement in Austria, the use of PPB may translate into cost savings of €219,600 and 621 saved operating facility hours.PPB has the potential to minimize the risk of lead damage with more efficient utilization of the operating room. Along with cost savings and improved quality of care, hospitals may use the saved operating room hours to increase the number of daily surgeries.CONCLUSIONPPB has the potential to minimize the risk of lead damage with more efficient utilization of the operating room. Along with cost savings and improved quality of care, hospitals may use the saved operating room hours to increase the number of daily surgeries. Intra-operative complications like mechanical damages to the leads, infections and hematomas during generator replacements of implantable pacemakers and defibrillators contribute to additional costs for hospitals. The aim of this study was to evaluate operation room use, costs and budget impact of generator replacements using either a traditional surgical intervention (TSI) with scissors, scalpel and electrocautery vs. a new radiofrequency energy based surgical system, called PEAK PlasmaBladeTM (PPB). We conducted a retrospective analysis of a population including 508 patients with TSI and 254 patients with PPB who underwent generator replacement at the Kepler University Hospital in Linz or the St. Josef Hospital in Braunau, Austria. The economic analysis included costs of resources used for intra-operative complications (lead damages) and of procedure time for TSI vs. PPB. Proportion of males, mean age and type of generator replaced were similar between the two groups. Lead damages occurred significantly more frequent with TSI than with PPB (5.3% and 0.4%; p< 0.001) and the procedure time was significantly longer with TSI than with PPB (47.9±24.9 and 34.1±18.1 minutes; p<0.001). Shorter procedure time and a lower rate of lead damages with PPB resulted in per patient cost savings of €81. Based on estimated 2,700 patients annually undergoing generator replacement in Austria, the use of PPB may translate into cost savings of €219,600 and 621 saved operating facility hours. PPB has the potential to minimize the risk of lead damage with more efficient utilization of the operating room. Along with cost savings and improved quality of care, hospitals may use the saved operating room hours to increase the number of daily surgeries. Introduction Intra-operative complications like mechanical damages to the leads, infections and hematomas during generator replacements of implantable pacemakers and defibrillators contribute to additional costs for hospitals. The aim of this study was to evaluate operation room use, costs and budget impact of generator replacements using either a traditional surgical intervention (TSI) with scissors, scalpel and electrocautery vs. a new radiofrequency energy based surgical system, called PEAK PlasmaBladeTM (PPB). Materials and methods We conducted a retrospective analysis of a population including 508 patients with TSI and 254 patients with PPB who underwent generator replacement at the Kepler University Hospital in Linz or the St. Josef Hospital in Braunau, Austria. The economic analysis included costs of resources used for intra-operative complications (lead damages) and of procedure time for TSI vs. PPB. Results Proportion of males, mean age and type of generator replaced were similar between the two groups. Lead damages occurred significantly more frequent with TSI than with PPB (5.3% and 0.4%; p< 0.001) and the procedure time was significantly longer with TSI than with PPB (47.9±24.9 and 34.1±18.1 minutes; p<0.001). Shorter procedure time and a lower rate of lead damages with PPB resulted in per patient cost savings of €81. Based on estimated 2,700 patients annually undergoing generator replacement in Austria, the use of PPB may translate into cost savings of €219,600 and 621 saved operating facility hours. Conclusion PPB has the potential to minimize the risk of lead damage with more efficient utilization of the operating room. Along with cost savings and improved quality of care, hospitals may use the saved operating room hours to increase the number of daily surgeries. Introduction Intra-operative complications like mechanical damages to the leads, infections and hematomas during generator replacements of implantable pacemakers and defibrillators contribute to additional costs for hospitals. The aim of this study was to evaluate operation room use, costs and budget impact of generator replacements using either a traditional surgical intervention (TSI) with scissors, scalpel and electrocautery vs. a new radiofrequency energy based surgical system, called PEAK PlasmaBlade TM (PPB). Materials and methods We conducted a retrospective analysis of a population including 508 patients with TSI and 254 patients with PPB who underwent generator replacement at the Kepler University Hospital in Linz or the St. Josef Hospital in Braunau, Austria. The economic analysis included costs of resources used for intra-operative complications (lead damages) and of procedure time for TSI vs. PPB. Results Proportion of males, mean age and type of generator replaced were similar between the two groups. Lead damages occurred significantly more frequent with TSI than with PPB (5.3% and 0.4%; p< 0.001) and the procedure time was significantly longer with TSI than with PPB (47.9±24.9 and 34.1±18.1 minutes; p<0.001). Shorter procedure time and a lower rate of lead damages with PPB resulted in per patient cost savings of €81. Based on estimated 2,700 patients annually undergoing generator replacement in Austria, the use of PPB may translate into cost savings of €219,600 and 621 saved operating facility hours. Conclusion PPB has the potential to minimize the risk of lead damage with more efficient utilization of the operating room. Along with cost savings and improved quality of care, hospitals may use the saved operating room hours to increase the number of daily surgeries. Intra-operative complications like mechanical damages to the leads, infections and hematomas during generator replacements of implantable pacemakers and defibrillators contribute to additional costs for hospitals. The aim of this study was to evaluate operation room use, costs and budget impact of generator replacements using either a traditional surgical intervention (TSI) with scissors, scalpel and electrocautery vs. a new radiofrequency energy based surgical system, called PEAK PlasmaBladeTM (PPB).We conducted a retrospective analysis of a population including 508 patients with TSI and 254 patients with PPB who underwent generator replacement at the Kepler University Hospital in Linz or the St. Josef Hospital in Braunau, Austria. The economic analysis included costs of resources used for intra-operative complications (lead damages) and of procedure time for TSI vs. PPB.Proportion of males, mean age and type of generator replaced were similar between the two groups. Lead damages occurred significantly more frequent with TSI than with PPB (5.3% and 0.4%; p< 0.001) and the procedure time was significantly longer with TSI than with PPB (47.9±24.9 and 34.1±18.1 minutes; p<0.001). Shorter procedure time and a lower rate of lead damages with PPB resulted in per patient cost savings of €81. Based on estimated 2,700 patients annually undergoing generator replacement in Austria, the use of PPB may translate into cost savings of €219,600 and 621 saved operating facility hours.PPB has the potential to minimize the risk of lead damage with more efficient utilization of the operating room. Along with cost savings and improved quality of care, hospitals may use the saved operating room hours to increase the number of daily surgeries. |
| Author | Steinwender, Clemens Edlinger, Christoph Kellermair, Joerg Nahler, Alexander Neeser, Kurt Lichtenauer, Michael Kypta, Alexander Kiblboeck, Daniel Kammler, Juergen Auer, Johannes Lambert, Thomas Blessberger, Hermann |
| AuthorAffiliation | 4 Department of Internal Medicine I, St. Josef Hospital, Braunau, Austria 3 Analytica Laser International Inc., Lörrach, Germany Klinikum Region Hannover GmbH, GERMANY 1 Department of Cardiology, Kepler University Hospital, Linz, Austria 2 Department of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria |
| AuthorAffiliation_xml | – name: 2 Department of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria – name: 1 Department of Cardiology, Kepler University Hospital, Linz, Austria – name: Klinikum Region Hannover GmbH, GERMANY – name: 3 Analytica Laser International Inc., Lörrach, Germany – name: 4 Department of Internal Medicine I, St. Josef Hospital, Braunau, Austria |
| Author_xml | – sequence: 1 givenname: Alexander orcidid: 0000-0002-5960-7742 surname: Kypta fullname: Kypta, Alexander – sequence: 2 givenname: Hermann surname: Blessberger fullname: Blessberger, Hermann – sequence: 3 givenname: Juergen surname: Kammler fullname: Kammler, Juergen – sequence: 4 givenname: Alexander surname: Nahler fullname: Nahler, Alexander – sequence: 5 givenname: Kurt surname: Neeser fullname: Neeser, Kurt – sequence: 6 givenname: Michael surname: Lichtenauer fullname: Lichtenauer, Michael – sequence: 7 givenname: Christoph surname: Edlinger fullname: Edlinger, Christoph – sequence: 8 givenname: Joerg surname: Kellermair fullname: Kellermair, Joerg – sequence: 9 givenname: Daniel surname: Kiblboeck fullname: Kiblboeck, Daniel – sequence: 10 givenname: Thomas surname: Lambert fullname: Lambert, Thomas – sequence: 11 givenname: Johannes surname: Auer fullname: Auer, Johannes – sequence: 12 givenname: Clemens surname: Steinwender fullname: Steinwender, Clemens |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29509774$$D View this record in MEDLINE/PubMed |
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| Copyright | 2018 Kypta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2018 Kypta et al 2018 Kypta et al |
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| DOI | 10.1371/journal.pone.0192587 |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: Kurt Neeser is a full-time employee of Laser Analytica. This does not alter our adherence to PLOS ONE policies and sharing data and materials. All authors declare they have no competing interests with respect to this manuscript and the topic covered. |
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| References_xml | – volume: 28 start-page: 388 issue: 4 year: 2007 ident: ref14 article-title: The high cost of implantable defibrillators publication-title: EHJ doi: 10.1093/eurheartj/ehl311 – volume: 34 start-page: 2281 issue: 29 year: 2013 ident: ref4 article-title: 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA) publication-title: EHJ doi: 10.1093/eurheartj/eht150 – volume: 67 start-page: 258 issue: 3 year: 1992 ident: ref12 article-title: Venous complications after insertion of a transvenous pacemaker publication-title: Mayo Clinic Proceedings doi: 10.1016/S0025-6196(12)60103-7 – volume: 5 start-page: 907 issue: 6 year: 2008 ident: ref1 article-title: HRS/EHRA expert consensus on the monitoring of cardiovascular implantable electronic devices (CIEDs): description of techniques, indications, personnel, frequency and ethical considerations publication-title: Heart Rhythm doi: 10.1016/j.hrthm.2008.04.013 – ident: ref3 – volume: 12 start-page: 692 issue: 5 year: 2010 ident: ref15 article-title: Tracing the European course of cardiac resynchronization therapy from 2006 to 2008 publication-title: Europace doi: 10.1093/europace/euq041 – volume: 155 start-page: 896 issue: 5 year: 2008 ident: ref2 article-title: Temporal trends in permanent pacemaker implantation: a population-based study publication-title: Am Heart J doi: 10.1016/j.ahj.2007.12.022 – volume: 39 start-page: 495 issue: 4 year: 1969 ident: ref11 article-title: Autopsy findings with permanent pervenous pacemakers publication-title: Circulation doi: 10.1161/01.CIR.39.4.495 – volume: 38 start-page: 28 issue: 1 year: 2015 ident: ref6 article-title: An Electrical Plasma Surgery Tool for Device Replacement–Retrospective Evaluation of Compications and Economic Evaluation of Costs and Resource Use publication-title: Pacing Clin Electrophysiol doi: 10.1111/pace.12488 – volume: 36 start-page: 2793 issue: 41 year: 2015 ident: ref5 article-title: 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC)Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC) publication-title: EHJ doi: 10.1093/eurheartj/ehv316 – volume: 5 start-page: 1 issue: 2 year: 2016 ident: ref13 article-title: Incidence and Costs Related to Lead Damage Within the First Year After a Cardiac Implantable Electrical Device Replacement Procedure publication-title: J Am Heart Assoc doi: 10.1161/JAHA.115.002813 – volume: 122 start-page: 1553 issue: 16 year: 2010 ident: ref7 article-title: Complication rates associated with pacemaker or implantable cardioverter-defibrillator generator replacements and upgrade procedures: results from the REPLACE registry publication-title: Circulation doi: 10.1161/CIRCULATIONAHA.110.976076 – volume: 17 start-page: 1 issue: Suppl 4 year: 2015 ident: ref10 article-title: Current trends in the use of cardiac implantable electronic devices and interventional electrophysiological procedures in the European Society of Cardiology member countries: 2015 report from the European Heart Rhythm Association publication-title: Europace doi: 10.1093/europace/euv265 – volume: 73 start-page: 1468 issue: 42 year: 1978 ident: ref8 article-title: Cardiovascular tissue response to intracardiac pacemaking (author's transl) publication-title: Medizinische Klinik – volume: 46 start-page: 409 issue: 2 year: 1972 ident: ref9 article-title: Surface thrombosis and fibrous encapsulation of intravenous pacemaker catheter electrode publication-title: Circulation doi: 10.1161/01.CIR.46.2.409 – reference: 1545594 - Mayo Clin Proc. 1992 Mar;67(3):258-65 – reference: 26320108 - Eur Heart J. 2015 Nov 1;36(41):2793-867 – reference: 23801822 - Eur Heart J. 2013 Aug;34(29):2281-329 – reference: 26286028 - Europace. 2015 Aug;17 Suppl 4:iv1-72 – reference: 703676 - Med Klin. 1978 Oct 20;73(42):1468-76 – reference: 20200017 - Europace. 2010 May;12(5):692-701 – reference: 17032689 - Eur Heart J. 2007 Feb;28(4):388-91 – reference: 26873688 - J Am Heart Assoc. 2016 Feb 12;5(2): – reference: 18551743 - Heart Rhythm. 2008 Jun;5(6):907-25 – reference: 18440339 - Am Heart J. 2008 May;155(5):896-903 – reference: 20921437 - Circulation. 2010 Oct 19;122(16):1553-61 – reference: 25154425 - Pacing Clin Electrophysiol. 2015 Jan;38(1):28-34 – reference: 5046033 - Circulation. 1972 Aug;46(2):409-12 – reference: 5778250 - Circulation. 1969 Apr;39(4):495-501 |
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| Snippet | Intra-operative complications like mechanical damages to the leads, infections and hematomas during generator replacements of implantable pacemakers and... Introduction Intra-operative complications like mechanical damages to the leads, infections and hematomas during generator replacements of implantable... Introduction Intra-operative complications like mechanical damages to the leads, infections and hematomas during generator replacements of implantable... |
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| SubjectTerms | Biology and Life Sciences Cardiac arrhythmia Cardiology Complications Cost analysis Cost engineering Cost reduction Costs Cutting tools Damage Defibrillators Economic analysis Economics Ethics Heart failure Hematoma Hospitals Intervention Males Medical innovations Medicine and Health Sciences Pacemakers Patients People and places Radio frequency Risk reduction Social Sciences Surgery Surgical implants Task forces Trends |
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| Title | Economic assessment of traditional surgical intervention versus use of a new innovative radiofrequency based surgical system in device replacements |
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