Hospital and institutionalisation care costs after limb and visceral ischaemia benchmarked against stroke: long-term results of a population-based cohort study

Objective/Background: There are few published data on the acute care or long-term costs after acute/critical limb or visceral ischaemia (ACLVI) events. Using data from patients with acute events in a population-based incidence study (Oxford Vascular Study), we aimed to determine the long-term costs after an ACLVI event. Methods: We studied all patients with first-ever incident ACLVI from 2002 to 2012. Analysis was based on follow-up until January 2017, with all patients having full 5-year follow-up. Multivariate regressions were used to assess baseline and subsequent predictors of total 5-year hospital care costs. Overall costs after an ACLVI event were benchmarked against those after stroke in the same population, during the same period. Results: Among 351 patients with an ACLVI event, mean 5-year total care costs were €35,211 (S.D. 50,500), of which €6,443 (18%) were due to long-term institutionalisation. Costs differed by type of event (acute visceral ischaemia €16,476; acute limb ischaemia €24,437; critical limb ischaemia €46,281; p<0.001). Results of the multivariate analyses showed that patients with diabetes and those undergoing above-knee amputations incurred additional costs of €11,804 (p=0.014) and €25,692 (p<0.001), respectively. 5-year hospital care costs after an ACLVI event were significantly higher than after stroke (€28,768 vs €22,623; p=0.004), but similar after including long-term costs of institutionalisation (€35,211 vs €35,391; p=0.957). Conclusion: Long-term care costs after an ACLVI event are considerable, especially after critical limb ischaemia. Hospital care costs were significantly higher than for stroke over the long-term, and were similar after inclusion of costs of institutionalisation