Kunz, Wolfgang G. and Sporns, Peter B. and Psychogios, Marios N. and Fiehler, Jens and Chapot, Rene and Dorn, Franziska and Grams, Astrid and Morotti, Andrea and Musolino, Patricia and Lee, Sarah and Kemmling, Andre and Henkes, Hans and Nikoubashman, Omid and Wiesmann, Martin and Jensen-Kondering, Ulf and Moehlenbruch, Markus and Schlamann, Marc and Marik, Wolfgang and Schob, Stefan and Wendl, Christina and Turowski, Bernd and Goetz, Friedrich and Kaiser, Daniel and Dimitriadis, Konstantinos and Gersing, Alexandra and Liebig, Thomas and Ricke, Jens and Reidler, Paul and Wildgruber, Moritz and Moench, Sebastian (2022) Cost-Effectiveness of Endovascular Thrombectomy in Childhood Stroke: An Analysis of the Save ChildS Study. JOURNAL OF STROKE, 24 (1). pp. 138-147. ISSN 2287-6391, 2287-6405
Full text not available from this repository. (Request a copy)Abstract
Background and Purpose The Save ChildS Study demonstrated that endovascular thrombectomy (EVT) is a safe treatment option for pediatric stroke patients with large vessel occlusions (LVOs) with high recanalization rates. Our aim was to determine the long-term cost, health consequences and cost-effectiveness of EVT in this patient population. Methods In this retrospective study, a decision-analytic Markov model estimated lifetime costs and quality-adjusted life years (QALYs). Early outcome parameters were based on the entire Save ChildS Study to model the EVT group. As no randomized data exist, the Save ChildS patient sub-group with unsuccessful recanalization was used to model the standard of care group. For model -ing of lifetime estimates, pediatric and adult input parameters were obtained from the current lit- erature. The analysis was conducted in a United States setting applying healthcare and societal perspectives. Probabilistic sensitivity analyses were performed. The willingness-to-pay threshold was set to $100,000 per QALY. Results The model results yielded EVT as the dominant (cost-effective as well as cost-saving) strategy for pediatric stroke patients. The incremental effectiveness for the average age of 11.3 years at first stroke in the Save ChildS Study was determined as an additional 4.02 lifetime QALYs, with lifetime cost-savings that amounted to $169,982 from a healthcare perspective and $254,110 when applying a societal perspective. Acceptability rates for EVT were 96.60% and 96.66% for the healthcare and societal perspectives. Conclusions EVT for pediatric stroke patients with LVOs resulted in added QALY and reduced lifetime costs. Based on the available data in the Save ChildS Study, EVT is very likely to be a cost-effective treatment strategy for childhood stroke.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ACUTE ISCHEMIC-STROKE; QUALITY-OF-LIFE; RECURRENT STROKE; MECHANICAL THROMBECTOMY; PLASMINOGEN-ACTIVATOR; HOSPITAL COSTS; UNITED-STATES; RISK-FACTORS; CARE COSTS; POPULATION; Pediatrics; Stroke; Thrombectomy; Cost-benefit analysis |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Zentrum für Neuroradiologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2023 07:21 |
| Last Modified: | 14 Dec 2023 07:21 |
| URI: | https://pred.uni-regensburg.de/id/eprint/58699 |
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