TY - JOUR
T1 - Pharmacoeconomical consequences of postoperative CSF leaks after intracranial surgery - A prospective analysis
AU - Piek, J.
AU - Weber, C.
AU - Kundt, G.
AU - Tronnier, V.
AU - Spuck, S.
AU - Hirdes, C.
AU - Kehler, U.
AU - Ditges, C.
PY - 2012
Y1 - 2012
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84880867246&partnerID=8YFLogxK
U2 - 10.1055/s-0032-1304501
DO - 10.1055/s-0032-1304501
M3 - Scientific review articles
C2 - 21932184
AN - SCOPUS:84880867246
SN - 2193-6315
VL - 73
SP - 25
EP - 28
JO - Journal of Neurological Surgery, Part A: Central European Neurosurgery
JF - Journal of Neurological Surgery, Part A: Central European Neurosurgery
IS - 1
ER -