Early Versus Delayed Surgical Decompression of Spinal Cord after Traumatic Cervical Spinal Cord Injury: A Cost-Utility Analysis

World Neurosurgery
Julio C FurlanMichael G Fehlings

Abstract

This cost-utility analysis was undertaken to compare early (≤24 hours since trauma) versus delayed surgical decompression of spinal cord to determine which approach is more cost effective in the management of patients with acute traumatic cervical spinal cord injury (SCI). This study includes the patients enrolled into the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS) and admitted at Toronto Western Hospital. Cases were grouped into patients with motor complete SCI and individuals with motor incomplete SCI. A cost-utility analysis was performed for each group of patients by the use of data for the first 6 months after SCI. The perspective of a public health care insurer was adopted. Costs were estimated in 2014 U.S. dollars. Utilities were estimated from the STASCIS. The baseline analysis indicates early spinal decompression is more cost-effective approach compared with the delayed spinal decompression. When we considered the delayed spinal decompression as the baseline strategy, the incremental cost-effectiveness ratio analysis revealed a saving of US$ 58,368,024.12 per quality-adjusted life years gained for patients with complete SCI and a saving of US$ 536,217.33 per quality-adjusted life years gained in patien...Continue Reading

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Citations

May 2, 2018·Neurosurgical Focus·Brian C F ChanJulio C Furlan
Oct 23, 2018·Clinical Spine Surgery : a Spine Publication·Sohaib Z HashmiAlpesh A Patel
Nov 2, 2017·Neurosurgical Focus·John K YueSanjay S Dhall
Nov 20, 2016·Current Reviews in Musculoskeletal Medicine·Eric FeuchtbaumLukas Zebala
Apr 10, 2019·Neural Regeneration Research·Shuo LiuBin Wang
Jan 29, 2019·Neural Regeneration Research·Xin ZhangJian-Jun Li
Jan 1, 2021·Trauma Surgery & Acute Care Open·Andrew J KerwinMarie L Crandall
Feb 13, 2021·Curēus·Islam MubarkNeil Ashwood
Apr 29, 2021·Neural Regeneration Research·Elliot H ChoiMichael Y Oh
Jul 22, 2021·Global Spine Journal·Hamid MalekzadehVafa Rahimi-Movaghar
Aug 26, 2021·Journal of Orthopaedic Surgery and Research·Jian-Jie WangRui Zhu
Dec 8, 2021·Minerva anestesiologica·Davide FurlanTiziana Bove

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