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Ad Hoc Cost Analysis of the New Gastrointestinal Bleeding Algorithm in Patients With Ventricular Assist Device

Hirose, Hitoshi; Sarosiek, Konrad; Cavarocchi, Nicholas C.

doi: 10.1097/MAT.0000000000000052
Brief Communication

Gastrointestinal bleed (GIB) is a known complication in patients receiving nonpulsatile ventricular assist devices (VAD). Previously, we reported a new algorithm for the workup of GIB in VAD patients using deep bowel enteroscopy. In this new algorithm, patients underwent fewer procedures, received less transfusions, and took less time to make the diagnosis than the traditional GIB algorithm group. Concurrently, we reviewed the cost-effectiveness of this new algorithm compared with the traditional workup. The procedure charges for the diagnosis and treatment of each episode of GIB was ~ $2,902 in the new algorithm group versus ~ $9,013 in the traditional algorithm group (p < 0.0001). Following the new algorithm in VAD patients with GIB resulted in fewer transfusions and diagnostic tests while attaining a substantial cost savings per episode of bleeding.

From the Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.

Submitted for consideration December 2013; accepted for publication in revised form January 2014.

Disclosure: The authors have no conflicts of interest to report.

Reprint Requests: Hitoshi Hirose, MD, Department of Surgery, Thomas Jefferson University Hospital, 1025 Walnut Street, Room 605, Philadelphia, PA 19107. Email:

Copyright © 2014 by the American Society for Artificial Internal Organs