The use of airway metallic stents for benign airway disorders continues to be popular, despite advisories to the contrary. We report the costs and healthcare resources utilization associated with endoscopic removal of airway metallic stents.
A retrospective review of a two centers’ experience in airway metallic stents removal over the period of January 2000 to April 2009. Healthcare resources utilization was analyzed in terms of number of procedures needed for stent removal, total number of procedures performed during each encounter (including stent removal, therapeutic aspiration, airway inspection, endobronchial therapy), and total days and costs of hospitalization and Intensive Care Unit (ICU) stay.
A total of 53 stents were removed from 44 patients over a 10-years period (53% females with a mean age of 58.6 years). 78% of the stents had been initially placed for benign airway disorders, mainly tracheobronchomalacia. The stents were in- situ for an average of 313 days (range from 7 to 1825 days). All procedures were performed under general anesthesia with a rigid bronchoscope using the traction method. The median number of procedures needed for stent removal was 1 (mean 1.46, range 1–4) with a median total number of procedures performed in each encounter of 2 (mean 2.62, range 1–8). 77% of the patients required hospitalization after their stent removal, mainly for airway monitoring, with a median hospital stay of 3 days (mean 7 days, range 1–27 days). Admission to the ICU was required in 34% of the encounters, with a median stay of 4 days (average 1–19 days). The mean total cost per encounter was 8,148 USD.
Endoscopic removal of metallic airway stents is associated with significant healthcare resources utilization and costs.
The use of metallic airway stents should be restricted to patients with advanced malignant airway diseases with short life expectancy where long-term complications requiring stent removal are less likely to occur.
Saleh Alazemi, No Financial Disclosure Information; No Product/Research Disclosure Information