Management of Hardware Related Infections after DBS Surgery
| Autor: | Mehmet Tonge, Ersoy Kocabicak, Linda Ackermans, Pieter L. Kubben, Silvia M. A. A. Evers, Tim A. M. Bouwens van der Vlis, Yasin Temel, Pim Wetzelaer |
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| Přispěvatelé: | RS: FPN CPS III, Section Clinical Psychology, RS: MHeNs - R3 - Neuroscience, Neurochirurgie, Promovendi MHN, MUMC+: MA AIOS Neurochirurgie (9), MUMC+: MA Med Staf Spec Neurochirurgie (9), RS: CAPHRI - R2 - Creating Value-Based Health Care, Health Services Research, OMÜ |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Prosthesis-Related Infections Deep brain stimulation Total cost medicine.drug_class Cost medicine.medical_treatment Antibiotics 03 medical and health sciences 0302 clinical medicine Hardware medicine Humans In patient 030212 general & internal medicine Prosthesis-Related Infection Activity-based costing health care economics and organizations RISK COMPLICATIONS SUBTHALAMIC NUCLEUS business.industry Middle Aged Anti-Bacterial Agents Electrodes Implanted Surgery Management Costs and Cost Analysis Cost analysis Female Neurology (clinical) DEEP-BRAIN-STIMULATION Complication business Infection 030217 neurology & neurosurgery Computer hardware |
| Zdroj: | Turkish Neurosurgery, 28(6), 929-933. Turkish Neurosurgical Society |
| ISSN: | 1019-5149 |
| Popis: | Evers, Silvia MAA/0000-0003-1026-570X; Tonge, Mehmet/0000-0002-0106-9363; Kubben, Pieter/0000-0002-8059-523X; Wetzelaer, Pim/0000-0002-7450-0046 WOS: 000450653000012 PubMed: 29465741 AIM: To investigate the costs of treating the infection with antibiotics only with the risk of surgery when unsuccessful versus immediate removal followed by re-implantation in patients with deep brain stimulation (DBS) hardware infection. MATERIAL and METHODS: We calculated the costs of the different strategies through a standard costing procedure. A decision model has been applied to establish the average treatment cost per patient representative for a clinical setting where both strategies are employed. Subsequently, a sensitivity analysis has been performed to assess the influence of clinical assumptions regarding the effectiveness of antibiotics treatment on average treatment costs. RESULTS: The costs of treating a case of DBS hardware infection with immediate internal pulse generator (IPG) replacement surgery were (sic)29,301 compared to (sic)9499 for successful antibiotic treatment. For antibiotic treatment followed by IPG replacement surgery the total costs were (sic)38,741. Antibiotic treatment alone was successful in 44% (4/9) of the included cases of DBS infection, resulting in average treatment costs per patient of (sic)26,745. Trying to resolve DBS hardware infections initially with antibiotics reduced treatment costs by 12.1%. CONCLUSION: Treatment with antibiotics with the risk of a later removal when unsuccessful was a more valuable strategy in terms of costs when compared to immediate surgical intervention in cases of hardware-related infections in DBS surgeries. |
| Databáze: | OpenAIRE |
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