Pharmacoeconomical consequences of postoperative CSF leaks after intracranial surgery - A prospective analysis

J. Piek*, C. Weber, G. Kundt, V. Tronnier, S. Spuck, C. Hirdes, U. Kehler, C. Ditges

*Korrespondierende/r Autor/-in für diese Arbeit
8 Zitate (Scopus)


Cerebrospinal fluid (CSF) leaks are well-known and frequent complications of intracranial procedures with their clinical aspects covered by numerous studies. Little, however, is known about the pharmacoeconomical aspects of this specific complication. 545 patients with a variety of intracranial procedures (elective and trauma) were recruited for a multicenter, prospective, observational study over a 13-month period. A specific pharmacoeconomic analysis was performed in 168 of these patients from the institution of the first author covering all clinical and pharmaco-economical aspects of this specific complication. Of all patients, 5.36% developed a postoperative CSF leak. Treatment of the leak required numerous diagnostic and therapeutic procedures such as reoperations (n = 6), lumbar punctures (n = 11) or lumbar drainages (n = 4). Costs for these procedures and prolonged hospital stays nearly doubled the costs per case (14079/case without a fistula vs. 25499/case with a fistula). Reimbursement for the hospital covered these extra costs, but net earnings per case were diminished by 565 in cases with a CSF leak. The authors conclude that the presence of a CSF leak after an intracranial operation - although not influencing outcome in general - results in additional diagnostic and therapeutic procedures for the patient, an enormous increase in costs for the community, and a financial loss for the hospital. Strategies to lower this complication rate should therefore urgently be developed both from a clinical and a pharmacoeconomical point of view.

ZeitschriftJournal of Neurological Surgery, Part A: Central European Neurosurgery
Seiten (von - bis)25-28
PublikationsstatusVeröffentlicht - 2012


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