Analysis of direct costs of decompressive craniectomy in victims of traumatic brain injury
ABSTRACT Background: Decompressive craniectomy is a procedure required in some cases of traumatic brain injury (TBI). This manuscript evaluates the direct costs and outcomes of decompressive craniectomy for TBI in a developing country and describes the epidemiological profile. Methods: A retrospecti...
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| Veröffentlicht in: | Arquivos de neuro-psiquiatria 2018-04, Vol.76 (4), p.257-264 |
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| creator | Badke, Guilherme Lellis Araujo, João Luiz Vitorino Miura, Flávio Key Guirado, Vinicius Monteiro de Paula Saade, Nelson Paiva, Aline Lariessy Campos Avelar, Tiago Marques Pedrozo, Charles Alfred Grander Veiga, José Carlos Esteves |
| description | ABSTRACT
Background:
Decompressive craniectomy is a procedure required in some cases of traumatic brain injury (TBI). This manuscript evaluates the direct costs and outcomes of decompressive craniectomy for TBI in a developing country and describes the epidemiological profile.
Methods:
A retrospective study was performed using a five-year neurosurgical database, taking a sample of patients with TBI who underwent decompressive craniectomy. Several variables were considered and a formula was developed for calculating the total cost.
Results:
Most patients had multiple brain lesions and the majority (69.0%) developed an infectious complication. The general mortality index was 68.8%. The total cost was R$ 2,116,960.22 (US$ 661,550.06) and the mean patient cost was R$ 66,155.00 (US$ 20,673.44).
Conclusions:
Decompressive craniectomy for TBI is an expensive procedure that is also associated with high morbidity and mortality. This was the first study performed in a developing country that aimed to evaluate the direct costs. Prevention measures should be a priority. |
| doi_str_mv | 10.1590/0004-282X20180016 |
| format | Article |
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Background:
Decompressive craniectomy is a procedure required in some cases of traumatic brain injury (TBI). This manuscript evaluates the direct costs and outcomes of decompressive craniectomy for TBI in a developing country and describes the epidemiological profile.
Methods:
A retrospective study was performed using a five-year neurosurgical database, taking a sample of patients with TBI who underwent decompressive craniectomy. Several variables were considered and a formula was developed for calculating the total cost.
Results:
Most patients had multiple brain lesions and the majority (69.0%) developed an infectious complication. The general mortality index was 68.8%. The total cost was R$ 2,116,960.22 (US$ 661,550.06) and the mean patient cost was R$ 66,155.00 (US$ 20,673.44).
Conclusions:
Decompressive craniectomy for TBI is an expensive procedure that is also associated with high morbidity and mortality. This was the first study performed in a developing country that aimed to evaluate the direct costs. Prevention measures should be a priority.</description><identifier>ISSN: 0004-282X</identifier><identifier>ISSN: 1678-4227</identifier><identifier>EISSN: 1678-4227</identifier><identifier>DOI: 10.1590/0004-282X20180016</identifier><identifier>PMID: 29742246</identifier><language>eng</language><publisher>Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil: Thieme Revinter Publicações Ltda</publisher><subject>Adolescent ; Adult ; Brain Injuries, Traumatic - economics ; Brain Injuries, Traumatic - surgery ; Brazil ; Costs ; craniectomia descompressiva ; custos e análise de custo ; Decompressive Craniectomy - economics ; Decompressive Craniectomy - statistics & numerical data ; Developing countries ; Female ; Glasgow Coma Scale ; Humans ; LDCs ; lesões encefálicas ; Male ; Middle Aged ; Morbidity ; Mortality ; NEUROSCIENCES ; Neurosurgery ; pressão intracraniana ; PSYCHIATRY ; Retrospective Studies ; Skull ; Traumatic brain injury ; Treatment Outcome ; Young Adult</subject><ispartof>Arquivos de neuro-psiquiatria, 2018-04, Vol.76 (4), p.257-264</ispartof><rights>Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon.</rights><rights>Copyright Arquivos de Neuro-Psiquiatria Apr 2018</rights><rights>This work is licensed under a Creative Commons Attribution 4.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c518t-bdc706a7bc2fa2f398824f3f426817b0075ff6cf358fdf0ca0b5a9e0f7cc574c3</citedby><cites>FETCH-LOGICAL-c518t-bdc706a7bc2fa2f398824f3f426817b0075ff6cf358fdf0ca0b5a9e0f7cc574c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.thieme-connect.de/products/ejournals/pdf/10.1590/0004-282X20180016.pdf$$EPDF$$P50$$Gthieme$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.thieme-connect.de/products/ejournals/html/10.1590/0004-282X20180016$$EHTML$$P50$$Gthieme$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,860,881,20870,27901,27902,54562,54590</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29742246$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Badke, Guilherme Lellis</creatorcontrib><creatorcontrib>Araujo, João Luiz Vitorino</creatorcontrib><creatorcontrib>Miura, Flávio Key</creatorcontrib><creatorcontrib>Guirado, Vinicius Monteiro de Paula</creatorcontrib><creatorcontrib>Saade, Nelson</creatorcontrib><creatorcontrib>Paiva, Aline Lariessy Campos</creatorcontrib><creatorcontrib>Avelar, Tiago Marques</creatorcontrib><creatorcontrib>Pedrozo, Charles Alfred Grander</creatorcontrib><creatorcontrib>Veiga, José Carlos Esteves</creatorcontrib><title>Analysis of direct costs of decompressive craniectomy in victims of traumatic brain injury</title><title>Arquivos de neuro-psiquiatria</title><addtitle>Arq Neuropsiquiatr</addtitle><description>ABSTRACT
Background:
Decompressive craniectomy is a procedure required in some cases of traumatic brain injury (TBI). This manuscript evaluates the direct costs and outcomes of decompressive craniectomy for TBI in a developing country and describes the epidemiological profile.
Methods:
A retrospective study was performed using a five-year neurosurgical database, taking a sample of patients with TBI who underwent decompressive craniectomy. Several variables were considered and a formula was developed for calculating the total cost.
Results:
Most patients had multiple brain lesions and the majority (69.0%) developed an infectious complication. The general mortality index was 68.8%. The total cost was R$ 2,116,960.22 (US$ 661,550.06) and the mean patient cost was R$ 66,155.00 (US$ 20,673.44).
Conclusions:
Decompressive craniectomy for TBI is an expensive procedure that is also associated with high morbidity and mortality. This was the first study performed in a developing country that aimed to evaluate the direct costs. Prevention measures should be a priority.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Brain Injuries, Traumatic - economics</subject><subject>Brain Injuries, Traumatic - surgery</subject><subject>Brazil</subject><subject>Costs</subject><subject>craniectomia descompressiva</subject><subject>custos e análise de custo</subject><subject>Decompressive Craniectomy - economics</subject><subject>Decompressive Craniectomy - statistics & numerical data</subject><subject>Developing countries</subject><subject>Female</subject><subject>Glasgow Coma Scale</subject><subject>Humans</subject><subject>LDCs</subject><subject>lesões encefálicas</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>NEUROSCIENCES</subject><subject>Neurosurgery</subject><subject>pressão intracraniana</subject><subject>PSYCHIATRY</subject><subject>Retrospective Studies</subject><subject>Skull</subject><subject>Traumatic brain injury</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0004-282X</issn><issn>1678-4227</issn><issn>1678-4227</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>0U6</sourceid><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNpdkk9v1DAQxS0EokvhA3BBkbhwSRn_i51jVZW2UiUOgIS4WM7EBq-S9WInFfvtcZtuKvVk2fN7z-M3JuQ9hTMqW_gMAKJmmv1kQDUAbV6QDW2UrgVj6iXZrPUT8ibnLQATbatekxPWqoKIZkN-ne_scMghV9FXfUgOpwpjnpa9wzjuk8s53LkKk92FUo_joQq76i7gFMYHbkp2Hu0UsOqSLaWw287p8Ja88nbI7t3jekp-fLn8fnFd3369urk4v61RUj3VXY8KGqs6ZN4yz1utmfDcC9ZoqjoAJb1v0HOpfe8BLXTStg68QpRKID8lN4tvH-3W7FMYbTqYaIN5OIjpt7GpNDc4w1u0nDVCdtoJ2rrWci81NkwIYUH3xets8coY3BDNNs6pBJTNt_sszVPWIEqaUhXBp0WwT_Hv7PJkxpDRDYPduThnw4CX11HGaUE_PkNXd0apoo0s1oWiC4Up5pycX19EwdxP3Rw7-XecetF8eHSeu9H1q-I45gLAAkx_ghvd08XPPdefxP8DC_Gy8Q</recordid><startdate>201804</startdate><enddate>201804</enddate><creator>Badke, Guilherme Lellis</creator><creator>Araujo, João Luiz Vitorino</creator><creator>Miura, Flávio Key</creator><creator>Guirado, Vinicius Monteiro de Paula</creator><creator>Saade, Nelson</creator><creator>Paiva, Aline Lariessy Campos</creator><creator>Avelar, Tiago Marques</creator><creator>Pedrozo, Charles Alfred Grander</creator><creator>Veiga, José Carlos Esteves</creator><general>Thieme Revinter Publicações Ltda</general><general>Arquivos de Neuro-Psiquiatria</general><general>Academia Brasileira de Neurologia - ABNEURO</general><general>Academia Brasileira de Neurologia (ABNEURO)</general><scope>0U6</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><scope>GPN</scope><scope>DOA</scope></search><sort><creationdate>201804</creationdate><title>Analysis of direct costs of decompressive craniectomy in victims of traumatic brain injury</title><author>Badke, Guilherme Lellis ; Araujo, João Luiz Vitorino ; Miura, Flávio Key ; Guirado, Vinicius Monteiro de Paula ; Saade, Nelson ; Paiva, Aline Lariessy Campos ; Avelar, Tiago Marques ; Pedrozo, Charles Alfred Grander ; Veiga, José Carlos Esteves</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c518t-bdc706a7bc2fa2f398824f3f426817b0075ff6cf358fdf0ca0b5a9e0f7cc574c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Brain Injuries, Traumatic - economics</topic><topic>Brain Injuries, Traumatic - surgery</topic><topic>Brazil</topic><topic>Costs</topic><topic>craniectomia descompressiva</topic><topic>custos e análise de custo</topic><topic>Decompressive Craniectomy - economics</topic><topic>Decompressive Craniectomy - statistics & numerical data</topic><topic>Developing countries</topic><topic>Female</topic><topic>Glasgow Coma Scale</topic><topic>Humans</topic><topic>LDCs</topic><topic>lesões encefálicas</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>NEUROSCIENCES</topic><topic>Neurosurgery</topic><topic>pressão intracraniana</topic><topic>PSYCHIATRY</topic><topic>Retrospective Studies</topic><topic>Skull</topic><topic>Traumatic brain injury</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Badke, Guilherme Lellis</creatorcontrib><creatorcontrib>Araujo, João Luiz Vitorino</creatorcontrib><creatorcontrib>Miura, Flávio Key</creatorcontrib><creatorcontrib>Guirado, Vinicius Monteiro de Paula</creatorcontrib><creatorcontrib>Saade, Nelson</creatorcontrib><creatorcontrib>Paiva, Aline Lariessy Campos</creatorcontrib><creatorcontrib>Avelar, Tiago Marques</creatorcontrib><creatorcontrib>Pedrozo, Charles Alfred Grander</creatorcontrib><creatorcontrib>Veiga, José Carlos Esteves</creatorcontrib><collection>Thieme Connect Journals Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>SciELO</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Arquivos de neuro-psiquiatria</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Badke, Guilherme Lellis</au><au>Araujo, João Luiz Vitorino</au><au>Miura, Flávio Key</au><au>Guirado, Vinicius Monteiro de Paula</au><au>Saade, Nelson</au><au>Paiva, Aline Lariessy Campos</au><au>Avelar, Tiago Marques</au><au>Pedrozo, Charles Alfred Grander</au><au>Veiga, José Carlos Esteves</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analysis of direct costs of decompressive craniectomy in victims of traumatic brain injury</atitle><jtitle>Arquivos de neuro-psiquiatria</jtitle><addtitle>Arq Neuropsiquiatr</addtitle><date>2018-04</date><risdate>2018</risdate><volume>76</volume><issue>4</issue><spage>257</spage><epage>264</epage><pages>257-264</pages><issn>0004-282X</issn><issn>1678-4227</issn><eissn>1678-4227</eissn><abstract>ABSTRACT
Background:
Decompressive craniectomy is a procedure required in some cases of traumatic brain injury (TBI). This manuscript evaluates the direct costs and outcomes of decompressive craniectomy for TBI in a developing country and describes the epidemiological profile.
Methods:
A retrospective study was performed using a five-year neurosurgical database, taking a sample of patients with TBI who underwent decompressive craniectomy. Several variables were considered and a formula was developed for calculating the total cost.
Results:
Most patients had multiple brain lesions and the majority (69.0%) developed an infectious complication. The general mortality index was 68.8%. The total cost was R$ 2,116,960.22 (US$ 661,550.06) and the mean patient cost was R$ 66,155.00 (US$ 20,673.44).
Conclusions:
Decompressive craniectomy for TBI is an expensive procedure that is also associated with high morbidity and mortality. This was the first study performed in a developing country that aimed to evaluate the direct costs. Prevention measures should be a priority.</abstract><cop>Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil</cop><pub>Thieme Revinter Publicações Ltda</pub><pmid>29742246</pmid><doi>10.1590/0004-282X20180016</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; Thieme Connect Journals Open Access |
| subjects | Adolescent Adult Brain Injuries, Traumatic - economics Brain Injuries, Traumatic - surgery Brazil Costs craniectomia descompressiva custos e análise de custo Decompressive Craniectomy - economics Decompressive Craniectomy - statistics & numerical data Developing countries Female Glasgow Coma Scale Humans LDCs lesões encefálicas Male Middle Aged Morbidity Mortality NEUROSCIENCES Neurosurgery pressão intracraniana PSYCHIATRY Retrospective Studies Skull Traumatic brain injury Treatment Outcome Young Adult |
| title | Analysis of direct costs of decompressive craniectomy in victims of traumatic brain injury |
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