Bedside femoral line placement
Abstract:
Purpose: To compare the direct bundled costs of interventional radiology (IR) suite versus bedside placement of non-cuffed central venous catheters in infants.
Materials and methods: A single center retrospective review was performed of all non-cuffed upper extremity (PICC) and tunneled femoral (TCVC) catheters placed in infants from January 1, 2018 to December 31, 2018. Propensity score matching was performed adjusting for age, birth weight, procedure weight and catheter days. Process maps for each procedure were created based on location and sedation type. Technical success and complications were recorded for each placement. The total direct bundled cost for each catheter placement was calculated by summing the procedure and complication costs.
Results: One hundred forty-two procedures were performed on 126 matched patients with a technical success of 96% at the bedside and 100% in the IR suite (p=0.08). Complication rates did not significantly differ between the two groups (p=0.51). The total direct bundled cost for catheter placement was $1421.3 + $2213.2 at the bedside and $2256.8 + $3264.7 in the IR suite (p=0.001).
Conclusion: The bundled cost of bedside femoral line placements is significantly less than fluoroscopic TCVC and PICC placements placed in the IR suite, mainly related to differences in sedation costs.
Reference:
Reis J, Koo KK, Shivaram GS, Shaw DW, Monroe EJ, Iyer RS. Time-Driven Cost Analysis of Non-cuffed Venous Catheter Placement in Infants: Bedside versus IR Suite. J Vasc Interv Radiol. 2021 Aug 3:S1051-0443(21)01271-9. doi: 10.1016/j.jvir.2021.07.020. Epub ahead of print. PMID: 34358685.