scholarly journals Effects of Radiation Exposure on the Cost-Effectiveness of CT Angiography and Perfusion Imaging in Aneurysmal Subarachnoid Hemorrhage

2017 ◽  
Vol 38 (3) ◽  
pp. 462-468 ◽  
Author(s):  
J. Ivanidze ◽  
R.A. Charalel ◽  
I. Shuryak ◽  
D. Brenner ◽  
A. Pandya ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cost Effectiveness ◽  
Radiation Exposure ◽  
Ct Angiography ◽  
Perfusion Imaging ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Effects Of Radiation ◽  
The Cost

Economic Analysis of Tirilazad Mesylate for Aneurysmal Subarachnoid Hemorrhage: Economic Evaluation of a Phase III Clinical Trial in Europe and Australia

1998 ◽  
Vol 14 (1) ◽  
pp. 145-160 ◽  
Author(s):  
Henry Glick ◽  
Richard Willke ◽  
Daniel Polsky ◽  
Ted Llana ◽  
Wayne M. Alves ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cost Effectiveness ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Controlled Trial ◽  
Cost Of Care ◽  
Phase Iii ◽  
Double Blind ◽  
Additional Information ◽  
Tirilazad Mesylate ◽  
The Cost

AbstractThis study used data from a multinational phase III randomized, double-blind, vehicle-controlled trial to evaluate the cost-effectiveness of tirilazad mesylate (Freedox®) in the treatment of aneurysmal subarachnoid hemorrhage. In men, therapy with 6 mg/kg per day of tirilazad mesylate was associated with significantly increased survival, increased cost of care, and ratios of cost per death averted that compare favorably with the ratios of other life and death interventions. In women, it appeared to have no effects on costs or survival. Further clinical studies may provide additional information about the cost-effectiveness of this intervention.

scholarly journals Mortality rates, hospital length of stay, and the cost of treating subarachnoid hemorrhage in older patients: institutional and geographical differences

1997 ◽  
Vol 2 (2) ◽  
pp. E1
Author(s):  
Christopher L. Taylor ◽  
Zhong Yuan ◽  
Warren R. Selman ◽  
Robert A. Ratcheson ◽  
Alfred A. Rimm
Keyword(s):  
New York ◽  
Subarachnoid Hemorrhage ◽  
Mortality Rate ◽  
Length Of Stay ◽  
Older Patients ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Hospital Length Of Stay ◽  
Annual Number ◽  
Geographical Differences ◽  
The Cost

The risk of disability and death and the cost of medical care are particularly high for patients with aneurysmal subarachnoid hemorrhage (SAH) who are 65 years of age or older. A retrospective analysis of 47,408 Medicare patients treated over an 8-year period was performed to determine whether a relationship exists between the mortality rate and surgical volume for older patients with SAH. The mortality rate, length of stay in the hospital, and cost of treatment for patients with SAH in California and New York were also compared. The mortality rate was 14.3% for patients with SAH who were 65 years old or older and who were treated surgically in hospitals in which an average of five or more craniotomies were performed per year; in hospitals averaging between one and five craniotomies annually the mortality rate was 18.4%; and in those averaging less than one such operation per year the rate was 20.5% (trend p = 0.01). There was no difference in the mortality rate for patients in California versus the rate for those in New York. Surgically and medically treated patients, respectively, left the hospital an average of 6.7 and 5.1 days sooner in California than in New York. The unadjusted average reimbursement from Medicare to hospitals for surgically treated patients averaged $1468 more in New York than in California (p < 0.0001), but was equivalent for medically treated patients in the two states. The mortality rate in older patients who are treated surgically for SAH may be inversely correlated with the annual number of craniotomies performed for SAH in patients 65 years of age or older at a given institution. Hospital stays for patients with SAH are significantly shorter in California than in New York.

scholarly journals Single Phase Dual-energy CT Angiography: One-stop-shop Tool for Evaluating Aneurysmal Subarachnoid Hemorrhage

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Qian Qian Ni ◽  
Chun Xiang Tang ◽  
Yan E Zhao ◽  
Chang Sheng Zhou ◽  
Guo Zhong Chen ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Ct Angiography ◽  
Single Phase ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
One Stop

Clinical utility and cost-effectiveness of CT-angiography in the diagnosis of nontraumatic subarachnoid hemorrhage

2014 ◽  
Vol 56 (10) ◽  
pp. 817-824 ◽  
Author(s):  
Ramazan Jabbarli ◽  
Mukesch Shah ◽  
Christian Taschner ◽  
Klaus Kaier ◽  
Beate Hippchen ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cost Effectiveness ◽  
Ct Angiography ◽  
Clinical Utility

Abstract TP423: Trends of Hospitalization Cost of Aneurysmal Subarachnoid Hemorrhage in the United States

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Sumul Modi ◽  
Kavit Shah ◽  
Muhammad Affan ◽  
Rizwan Tahir ◽  
Panayiotis Varelas ◽  
...  
Keyword(s):  
United States ◽  
Ischemic Stroke ◽  
Subarachnoid Hemorrhage ◽  
Respiratory Failure ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
The United States ◽  
Male Gender ◽  
Cost Of Care ◽  
Hospitalization Cost ◽  
The Cost

Background: Recent large scale studies describing the trends of hospitalization cost secondary to aneurysmal subarachnoid hemorrhage (aSAH) in the United States are lacking. We performed this study to discover these trends and the factors affecting the cost of hospitalization. Methods: The Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project from year 2002 to 2013 was searched for patients with a primary diagnosis of subarachnoid hemorrhage International Classification of Diseases - Ninth Revision (ICD-9) code 430) who underwent either clipping or coiling of an aneurysm. Patients with traumatic intracranial hemorrhage, arteriovenous malformation, arteriovenous fistula, cost of care ≤ 0, discharge to another hospital, and any missing variables were excluded. The cost of hospitalization was calculated using total charge and cost-to-charge ratio provided by HCUP, and then was adjusted for inflation (for the year 2016) utilizing the Consumer Price Index inflation calculator. Univariate and multivariable linear regression analysis was performed on selected variables to identify the factors associated with a higher cost of care. The multivariable model was adjusted for calendar year, medical comorbidities (using the Charlson Comorbidity Index), hospital location (urban or rural) and hospital teaching status (teaching or non-teaching). Results: We identified 20,905 patients with aSAH over the course of the 12 years. The mean and the median costs of hospitalization were $80,859 and $66,274, respectively. The median cost increased from $53,697 in 2002 to $73,901 in 2013 (p<0.001). Cost was also noted to increase by $2690 with the male gender, $18,877 with the presence of an acute ischemic stroke, $33,942 with the presence of respiratory failure and $18,464 with the requirement of ventriculostomy (all p<0.001). Every decade increase in age was associated with $3022 reduction in the cost (P<0.001). Conclusion: Among the factors we studied, higher hospitalization cost was independently associated with the male gender and the presence of ischemic stroke, respiratory failure and the requirement of ventriculostomy. Older age was associated with a lower hospitalization cost.

Abstract TP461: Screening CT Angiography to Identify Patients at Low Risk for Delayed Cerebral Ischemia Following Subarachnoid Hemorrhage

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Andrew Nguyen ◽  
Craig A Williamson ◽  
Aditya S Pandey ◽  
Kyle M Sheehan ◽  
Venkatakrishna Rajajee
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Ct Angiography ◽  
Predictive Value ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia ◽  
Subsequent Development ◽  
Low Risk ◽  
Eligibility Criteria ◽  
Risk Period

Introduction: Delayed Cerebral Ischemia (DCI) occurs during a risk period of 3-21 days following aneurysmal subarachnoid hemorrhage (aSAH) and is associated with worse outcomes. The identification of patients at low risk for DCI might permit triage to less intense monitoring and management. While large-vessel vasospasm (LVV) is a distinct clinical entity from DCI, the presence of moderate-severe LVV is associated with a higher risk of DCI. Hypothesis: The absence of moderate-severe LVV on screening CT angiography (CTA) performed within the first few days of the DCI risk period will accurately identify patients at low risk for subsequent DCI. Methods: Our institutional SAH outcomes registry was queried for all aSAH patients admitted 2016 - 2019 who underwent CTA brain between days 4-8 following ictus. We excluded patients who suffered DCI prior to this CTA study. All variables are prospectively entered into the registry, and outcomes including DCI and LVV are prospectively adjudicated. We evaluated the accuracy of moderate-severe LVV on CTA performed 4-8 days from ictus for the prediction of subsequent DCI, with a focus on the Negative Predictive Value (NPV). Results: A total of 243 aSAH patients were admitted during the study timeframe and 76 (31%) underwent CTA during the 4-8 day window following ictus. Of these, 22 were excluded for occurrence of DCI prior to the CTA study. Of 54 patients meeting eligibility criteria, 11 (20%) had moderate-severe LVV on the screening CTA study performed during the risk period. Seven of 11 (64%) patients with moderate-severe LVV on the day 4-8 screening CTA, vs 6 of 43 (14%) patients without, subsequently developed DCI. The NPV of CTA performed during days 4-8 for the subsequent development of DCI was 86% (95%CI 77-92%). Sensitivity was 54% (25-81%), Specificity 90% (77-97%) and Positive Predictive Value 64% (38-83%). Conclusions: The NPV of screening CTA performed between days 4-8 following SAH for the subsequent development of DCI was moderate, at 86%. The population studied likely represents a high-risk cohort, however, prospective studies of alternate risk-stratification strategies are necessary.

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