Background

Percutaneous mitral valve repair (pMVR) is reimbursed in France for severe secondary mitral regurgitation (SMR), but French data regarding the hospitalization index stay are lacking.

Aims

Our objectives were to describe the index hospitalization stay and to evaluate the cost of hospital stay for pMVR used in SMR.

Methods

A secondary evaluation based on patients who were randomized to the intervention group of the MITRA-FR study was undertaken. The economic evaluation was conducted according to the French hospital perspective. Medical resource use was estimated using specific data collected from patients enrolled in the MITRA-FR study and non-specific data from national statistics.

Results

The population was represented by 144 patients who underwent pMVR at 33 French centres. There was a mean ± standard deviation of 7.9 ± 1.5 hospital staff during procedures. The mean procedure duration was 154 ± 68 minutes and increased with the number of implanted clips. Median total length of stay was 8 days. The occurrence of a serious adverse event was not associated with an increased risk of admission to the critical care unit, but was associated with an increased length of stay. The mean total cost was 28,025 ± 3424 €, which includes 21,547 € for the cost of medical devices used during pMVR and 6478 ± 3424 € for other costs.

Conclusion

The cost of pMVR is substantial for patients with SMR, which advocates for further efforts to identify the patients with SMR who are likely to derive a clear clinical benefit from the procedure.

中文翻译：

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严重继发性二尖瓣关闭不全的经皮二尖瓣修复术：基于 MITRA-FR 试验的住院指标分析和经济评价

背景

经皮二尖瓣修复术 (pMVR) 在法国因严重继发性二尖瓣关闭不全 (SMR) 报销，但缺乏关于住院指数的法国数据。

宗旨

我们的目标是描述指数住院时间并评估 SMR 中使用的 pMVR 的住院费用。

方法

对随机分配到 MITRA-FR 研究干预组的患者进行了二次评估。经济评价是根据法国医院的观点进行的。使用从参与 MITRA-FR 研究的患者收集的特定数据和来自国家统计数据的非特定数据估计医疗资源的使用。

结果

该人群由 144 名在 33 个法国中心接受 pMVR 的患者代表。在手术过程中，有 7.9 ± 1.5 名医院工作人员的平均值 ± 标准差。平均手术持续时间为 154 ± 68 分钟，并随着植入夹子的数量而增加。中位总住院天数为 8 天。严重不良事件的发生与入住重症监护病房的风险增加无关，但与住院时间增加有关。平均总成本为 28,025 ± 3424欧元，其中包括 pMVR期间使用的医疗设备成本 21,547欧元和其他成本6478 ± 3424欧元。           

结论

pMVR 的成本对于 SMR 患者来说是巨大的，这提倡进一步努力确定可能从该手术中获得明显临床益处的 SMR 患者。