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Costs Associated With Timely and Delayed Surgical Treatment of Spinal Metastases

STUDY DESIGN: Retrospective cohort study. OBJECTIVES: Symptoms caused by spinal metastases are often difficult to distinguish from symptoms caused by non-malignant spinal disease, complicating timely diagnosis, referral and treatment. The ensuing delays may promote the risk of neurological deficits...

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Autores principales: van Tol, Floris R., Massier, Julie R. A., Frederix, Geert W. J., Öner, F. Cumhur, Verkooijen, Helena M., Verlaan, Jorrit-Jan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9609516/
https://www.ncbi.nlm.nih.gov/pubmed/33511876
http://dx.doi.org/10.1177/2192568220984789
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author van Tol, Floris R.
Massier, Julie R. A.
Frederix, Geert W. J.
Öner, F. Cumhur
Verkooijen, Helena M.
Verlaan, Jorrit-Jan
author_facet van Tol, Floris R.
Massier, Julie R. A.
Frederix, Geert W. J.
Öner, F. Cumhur
Verkooijen, Helena M.
Verlaan, Jorrit-Jan
author_sort van Tol, Floris R.
collection PubMed
description STUDY DESIGN: Retrospective cohort study. OBJECTIVES: Symptoms caused by spinal metastases are often difficult to distinguish from symptoms caused by non-malignant spinal disease, complicating timely diagnosis, referral and treatment. The ensuing delays may promote the risk of neurological deficits or severe mechanical instability and consequent emergency surgery, leading to poorer prognosis. Presumably, treatment delay may subsequently lead to more health-care consumption and therefore increased average costs of treatment. METHODS: All patients surgically treated for spinal metastases were included in the current study. Based on the presence of alarming symptoms and urgency of the required intervention, patients were categorized as having received timely or delayed treatment. Pre-surgical, in-hospital, aftercare and total costs were analyzed and compared between the 2 groups. RESULTS: In total, 299 patients were included, of which 205 underwent timely and 94 delayed treatment. There was no significant difference in pre-surigcal costs (€3.229,13 in the timely treated group vs. €2.528,70 in the delayed treatment group, p = 0.849). The in-hospital costs (€16.738,49 vs. €13.108,81, p < 0.001) and the aftercare costs (€13.950,37 vs. 3.981,93, p < 0.001) were significantly higher for delayed treatment vs. timely treatment, respectively. The total costs were €33.741,71 for delayed treatment and €20.318,52 for timely treatment (p < 0.001). CONCLUSIONS: The total costs for timely treated patients with spinal metastases are significantly lower compared with patients receiving delayed treatment. Investing in the optimization of referral patterns may therefore reduce the overall pretreatment delay and subsequently increase patient outcome, leading to better clinical outcomes at lower costs.
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spelling pubmed-96095162022-10-28 Costs Associated With Timely and Delayed Surgical Treatment of Spinal Metastases van Tol, Floris R. Massier, Julie R. A. Frederix, Geert W. J. Öner, F. Cumhur Verkooijen, Helena M. Verlaan, Jorrit-Jan Global Spine J Original Articles STUDY DESIGN: Retrospective cohort study. OBJECTIVES: Symptoms caused by spinal metastases are often difficult to distinguish from symptoms caused by non-malignant spinal disease, complicating timely diagnosis, referral and treatment. The ensuing delays may promote the risk of neurological deficits or severe mechanical instability and consequent emergency surgery, leading to poorer prognosis. Presumably, treatment delay may subsequently lead to more health-care consumption and therefore increased average costs of treatment. METHODS: All patients surgically treated for spinal metastases were included in the current study. Based on the presence of alarming symptoms and urgency of the required intervention, patients were categorized as having received timely or delayed treatment. Pre-surgical, in-hospital, aftercare and total costs were analyzed and compared between the 2 groups. RESULTS: In total, 299 patients were included, of which 205 underwent timely and 94 delayed treatment. There was no significant difference in pre-surigcal costs (€3.229,13 in the timely treated group vs. €2.528,70 in the delayed treatment group, p = 0.849). The in-hospital costs (€16.738,49 vs. €13.108,81, p < 0.001) and the aftercare costs (€13.950,37 vs. 3.981,93, p < 0.001) were significantly higher for delayed treatment vs. timely treatment, respectively. The total costs were €33.741,71 for delayed treatment and €20.318,52 for timely treatment (p < 0.001). CONCLUSIONS: The total costs for timely treated patients with spinal metastases are significantly lower compared with patients receiving delayed treatment. Investing in the optimization of referral patterns may therefore reduce the overall pretreatment delay and subsequently increase patient outcome, leading to better clinical outcomes at lower costs. SAGE Publications 2021-01-29 2022-10 /pmc/articles/PMC9609516/ /pubmed/33511876 http://dx.doi.org/10.1177/2192568220984789 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
van Tol, Floris R.
Massier, Julie R. A.
Frederix, Geert W. J.
Öner, F. Cumhur
Verkooijen, Helena M.
Verlaan, Jorrit-Jan
Costs Associated With Timely and Delayed Surgical Treatment of Spinal Metastases
title Costs Associated With Timely and Delayed Surgical Treatment of Spinal Metastases
title_full Costs Associated With Timely and Delayed Surgical Treatment of Spinal Metastases
title_fullStr Costs Associated With Timely and Delayed Surgical Treatment of Spinal Metastases
title_full_unstemmed Costs Associated With Timely and Delayed Surgical Treatment of Spinal Metastases
title_short Costs Associated With Timely and Delayed Surgical Treatment of Spinal Metastases
title_sort costs associated with timely and delayed surgical treatment of spinal metastases
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9609516/
https://www.ncbi.nlm.nih.gov/pubmed/33511876
http://dx.doi.org/10.1177/2192568220984789
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