The impact of waiting for intervention on costs and effectiveness: the case of transcatheter aortic valve replacement.

Objectives: The economic crisis in Europe might have limited access to some innovative technologies implying an increase of waiting time. The purpose of the study is to evaluate the impact of waiting time on the costs and benefits of transcatheter aortic valve replacement (TAVR) for the treatment of severe aortic stenosis.

Methods: This is a cost-utility analysis from the perspective of the Spanish National Health Service.

Transfemoral transcatheter aortic valve replacement compared with surgical replacement in patients with severe aortic stenosis and comparable risk: cost-utility and its determinants.

Objective: To evaluate cost-effectiveness of transfemoral TAVR vs surgical replacement (SAVR) and its determinants in patients with severe symptomatic aortic stenosis and comparable risk.

Methods: Patients were prospectively recruited in 6 Spanish hospitals and followed up over one year. We estimated adjusted incremental cost-effectiveness ratio (ICER) (Euros per quality-adjusted life-year [QALY] gained) using a net-benefit approach and assessed the determinants of incremental net-benefit of TAVR vs SAVR.

Improvements in health-related quality of life of patients admitted for heart failure. The HF-QoL study.

Introduction And Objectives: Heart failure (HF) is associated with a poor prognosis, both in terms of survival and ongoing symptoms. The objectives of this study were to investigate trends in the health-related quality of life (HRQoL) of a heterogeneous group of HF patients, with a focus on subgroups of particular clinical interest, and to identify determinants of mortality.

Methods: Prospective study of 883 HF patients discharged from 50 Spanish hospitals and followed for 1 year, during which six HRQoL assessments were carried out using the generic Short Form-36 (SF-36) questionnaire and the specific Minnesota Living with Heart Failure Questionnaire (MLHFQ).

Predicting in-hospital mortality with coronary bypass surgery using hospital discharge data: comparison with a prospective observational study.

Introduction And Objectives: The aim was to determine the usefulness of the hospital discharge Minimum Basic Data Set (MBDS) for predicting in-hospital mortality with coronary bypass surgery by using data from a prospective observational study as a reference.

Methods: The observational study involved collecting data on all patients undergoing first coronary bypass surgery at five hospitals in Catalonia, Spain between November 2001 and November 2003. In addition, data covering the same period and hospitals were obtained from the MBDS for procedure code 36.

The EuroSCORE and a local model consistently predicted coronary surgery mortality and showed complementary properties.

Objective: To revalidate a local model for prediction of in-hospital mortality after coronary surgery several years after its introduction and the EuroSCORE in a specific area within its original scope. To assess the specific advantages of one type of instrument over the other in a definite context.

Study Design And Setting: Data from consecutive patients undergoing a first isolated coronary artery bypass between November 2001 and November 2003 in five hospitals in Catalonia were prospectively collected.

[Baseline characteristics and determinants of outcome in a patient population admitted for heart failure to a general hospital].

Introduction And Objectives: To assess baseline characteristics, management patterns, and clinical outcomes after 18 months in patients diagnosed as heart failure in a tertiary hospital in Catalonia, Spain.

Methods: The records of all 265 patients admitted to the Hospital General Vall d'Hebron from July through December 1998 with a diagnosis of heart failure who met study criteria were identified and analyzed. Patients were interviewed by telephone 18 months later.