Association of Implementation of Operating Room-Based Parathyroid Hormone Testing with Operative Time and Cost.
Journal
Journal of the American College of Surgeons
ISSN: 1879-1190
Titre abrégé: J Am Coll Surg
Pays: United States
ID NLM: 9431305
Informations de publication
Date de publication:
01 12 2022
01 12 2022
Historique:
pubmed:
15
9
2022
medline:
19
11
2022
entrez:
14
9
2022
Statut:
ppublish
Résumé
Intraoperative parathyroid hormone (IOPTH) testing facilitates focused parathyroidectomy to establish biochemical cure but may be time-consuming. A dedicated immunoassay machine was relocated to the operating room for IOPTH. These data seek to determine association of operating room-based IOPTH with operative time, laboratory turnaround time (TAT), and cost. Patients who underwent parathyroidectomy from June 2017 to February 2020 were reviewed. Clinical and demographic data, operative time, and TAT were collected. Patients were compared by operation dates pre- or post-machine acquisition. A cost model was created to evaluate cost of care before and after operating room-based testing. A total of 285 patients were included. Post-machine, median operative time decreased from 69 minutes (interquartile range [IQR] 60 to 84) to 57 minutes (IQR 50 to 84.5), p 0.03. Additionally, median TAT for IOPTH values (preoperative, 0, 5, 10, and 15 minutes) decreased post-machine: time preoperative, 29 minutes (IQR 23 to 40) vs 18 minutes (IQR 17 to 23.5), p < 0.001; time 0, 33 minutes (IQR 27 to 39) vs 18.5 minutes (17.5 to 21), p < 0.001; time 5 minutes, 31 minutes (IQR 26 to 36) vs 20 minutes (IQR 18.5 to 21), p < 0.001; time 10 minutes, 32 minutes (IQR 27 to 39) vs 20 minutes (IQR 18.5 to 22.5), p < 0.001; and time 15 minutes, 30 minutes (IQR 26 to 36) vs 19 minutes (IQR 17 to 21), p < 0.001. Total costs pre- and post-machine were $4,442 and $4,111, respectively. With $331 cost reduction per operation and 127 operations per year, the IOPTH machine pays for itself in 3 years, or 378 surgeries, and saves $168,589 in the machine's remaining 4-year life span. Operating room-based parathyroid hormone testing results in improved operating productivity by decreasing result TAT and operative time and reduces cost.
Sections du résumé
BACKGROUND
Intraoperative parathyroid hormone (IOPTH) testing facilitates focused parathyroidectomy to establish biochemical cure but may be time-consuming. A dedicated immunoassay machine was relocated to the operating room for IOPTH. These data seek to determine association of operating room-based IOPTH with operative time, laboratory turnaround time (TAT), and cost.
METHODS
Patients who underwent parathyroidectomy from June 2017 to February 2020 were reviewed. Clinical and demographic data, operative time, and TAT were collected. Patients were compared by operation dates pre- or post-machine acquisition. A cost model was created to evaluate cost of care before and after operating room-based testing.
RESULTS
A total of 285 patients were included. Post-machine, median operative time decreased from 69 minutes (interquartile range [IQR] 60 to 84) to 57 minutes (IQR 50 to 84.5), p 0.03. Additionally, median TAT for IOPTH values (preoperative, 0, 5, 10, and 15 minutes) decreased post-machine: time preoperative, 29 minutes (IQR 23 to 40) vs 18 minutes (IQR 17 to 23.5), p < 0.001; time 0, 33 minutes (IQR 27 to 39) vs 18.5 minutes (17.5 to 21), p < 0.001; time 5 minutes, 31 minutes (IQR 26 to 36) vs 20 minutes (IQR 18.5 to 21), p < 0.001; time 10 minutes, 32 minutes (IQR 27 to 39) vs 20 minutes (IQR 18.5 to 22.5), p < 0.001; and time 15 minutes, 30 minutes (IQR 26 to 36) vs 19 minutes (IQR 17 to 21), p < 0.001. Total costs pre- and post-machine were $4,442 and $4,111, respectively. With $331 cost reduction per operation and 127 operations per year, the IOPTH machine pays for itself in 3 years, or 378 surgeries, and saves $168,589 in the machine's remaining 4-year life span.
CONCLUSIONS
Operating room-based parathyroid hormone testing results in improved operating productivity by decreasing result TAT and operative time and reduces cost.
Identifiants
pubmed: 36102508
doi: 10.1097/XCS.0000000000000362
pii: 00019464-202212000-00013
doi:
Substances chimiques
Parathyroid Hormone
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
906-912Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.
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