JTCS Email Content Delivery
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
YingXing Wu
Gary L. Grunkemeier
Albert Starr
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wu, Y.
Right arrow Articles by Starr, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wu, Y.
Right arrow Articles by Starr, A.
Related Collections
Right arrowRelated Articles

J Thorac Cardiovasc Surg 2007;133:603-607
© 2007 The American Association for Thoracic Surgery

Statistics for the Rest of Us

The value of aortic valve replacement in elderly patients: An economic analysis

YingXing Wu, MD*, Gary L. Grunkemeier, PhD, Albert Starr, MD

Providence Heart and Vascular Institute, Providence Health System, Portland, Ore.

Received for publication April 17, 2006; revisions received July 13, 2006; accepted for publication August 7, 2006.

* Address for reprints: YingXing Wu, MD, Providence Health System, 9205 SW Barnes, Suite 33, Portland, OR 97225. (Email: yingxing.wu{at}providence.org).

Objective: Economists have designed frameworks to measure the economic value of improvements in health and longevity. Heart valve replacement surgery has significantly prolonged life expectancy and quality of life. For the example of aortic valve replacement, what is its economic value according to this framework?

Methods: From 1961 through 2003, a total of 4617 adult patients underwent aortic valve replacement by one team of cardiac surgeons. These patients were provided with a prospective lifetime follow-up service. As of 2005, observed follow-up was 31,671 patient-years, with a maximum of 41 years. A statistical model was used to generate the future life-years of patients currently alive. The value of life-years proposed by economists was applied to determine the economic value of the additional life given to these patients by aortic valve replacement.

Results: The total life-years after aortic valve replacement were 53,323, with a gross value of $14.6 billion. The total expected life-years without surgery were 10,157, with an estimated value of $3.0 billion. Thus the net life-years gained by AVR were 43,166, worth $11.6 billion. Subtracting the $451 million total lifetime cost of surgery, the net value of the life-years gained by AVR was $11.2 billion. The mean net value decreases according to age at surgery but is still worth $600,000 for octogenarians and $200,000 for nonagenarians.

Conclusion: According to the economic concept of the value of a statistical life, the return on the investment for aortic valve replacement is enormous for patients of all ages, even very elderly patients.

Abbreviations and Acronyms AVR = aortic valve replacement


Related Articles

The cost and value of cardiothoracic procedures
Albert Starr and Gary L. Grunkemeier
J. Thorac. Cardiovasc. Surg. 2007 133: 601-602. [Extract] [Full Text] [PDF]

Cost-effectiveness of aortic valve replacement in the elderly: An introductory study
YingXing Wu, Ruyun Jin, Guangqiang Gao, Gary L. Grunkemeier, and Albert Starr
J. Thorac. Cardiovasc. Surg. 2007 133: 608-613. [Abstract] [Full Text] [PDF]





HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2007 by The American Association for Thoracic Surgery.