To predict hospital costs after coronary artery bypass grafting (CABG) from preoperative char acteristics and postoperative complications, 4 analyses of the data were used: (1) a univariate analysis of each preoperative and postoperative variable, (2) a multivariate analysis of the preoperative variables (model 1), (3) a multivariate analysis of the postoperative variables (model 2), and (4) a multivariate analysis of pre- and postoperative variables (model 3). Eight-hundred seven patients who underwent a first time CABG at Emery University during 1990 were analyzed in this study. Using model 1, the determinants of costs were higher angina grade (p = 0.0006), previous myocardial infarction (p = 0.0133), older age (p = 0.0001), congestive heart failure (p = 0.0001), and a higher number of diseased vessels (p = 0.0001). For model 2, the determinants of costs were adult respiratory distress syndrome (p = 0.0073), intraaortic: balloon pumping (p < 0.0001), pneumonia (p < 0.0001), septicemia (p < 0.0001), major arrhythmia (p < 0.0001), reexploration for bleeding (p < 0.0001), wound infection (p = 0.0632), neurologic event (p = 0.0013), fluid overload (p = 0.0516), and absence of pericarditis (p = 0.0588). For univariate analysis, the determinants of increased costs were similar to those from models 1 and 2. Although there is considerable variance in hospital costs for any number of complications, utilized resources (costs) increase inexorably as patients have mere complications after coronary surgery. The mean cost to the hospital for the 382 patients who underwent CABG and experienced no complications was $16,776. For patients who experienced only 1 complication, the mean cost to the hospital increased just slightly to $17,794. After 1 complication, the costs continued to increase as the number of complications increased. The upper extreme reveals that 14 patients experienced 5 complications utilizing an average of $50,609 in hospital resources.
