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首页> 外文期刊>Acta Neurochirurgica >Shunt surgery in idiopathic normal pressure hydrocephalus is cost-effective—a cost utility analysis
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Shunt surgery in idiopathic normal pressure hydrocephalus is cost-effective—a cost utility analysis

机译：特发性正常压力脑积水的分流手术是成本效益的 - 一种成本实用程序分析

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Abstract Background The objective was to evaluate the cost-effectiveness of shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH). Methods Health-related quality of life was evaluated before and 6?months after surgery using the EQ-5D-3?L (EuroQOL group five-dimensions health survey) in 30 patients (median age, 71?years; range, 65–89?years) diagnosed with iNPH. The costs associated with shunt surgery were assessed by a detailed survey with interviews and extraction of register data concerning the cost of hospital care, primary care, residential care, home-care service and informal care. The cost of untreated patients was derived from the cost of dementia disorders in Sweden in 2012, as reported by the National Board of Health and Welfare. The cost effectiveness analysis used a decision-analytic Markov model. We used a societal perspective and a lifelong time horizon to estimate costs and effects. One-way sensitivity analysis and probabilistic sensitivity analysis were carried out to test the robustness of the model. Results The shunt surgery model as the standard treatment in iNPH resulted in a gain of 2.2 life years and 1.7 quality-adjusted life years (QALY), along with an incremental cost per patient of ?7,500/QALY. The sensitivity analysis showed that the results were not sensitive to changes in uncertain parameters or assumptions. Conclusions Shunt surgery in iNPH, an underdiagnosed condition severely impairing elderly patients, is not only an effective medical treatment, it is also cost-effective, adding 2.2 additional life years and 1.7 QALYs at a low cost, a remarkable gain for an individual aged around 70?years.
机译：摘要背景目标是评估特发性常压患者分流手术的成本效益（INOW）。方法在30名患者中使用EQ-5D-3？L（欧洲QOL集团五维健康调查）在手术之前和6个月（中位年龄，71岁以下的欧元QOL组五维健康调查）评估了与卫生相关的生活质量评估。诊断出inph的年份）。通过详细的调查评估了与分流手术相关的成本，并通过对医院护理，初级保健，住宅护理，家庭护理服务和非正式护理的成本进行了详细的调查。未经处理的患者的成本来自于2012年瑞典痴呆症疾病的成本，由国家健康和福利委员会报道。成本效益分析使用了决策分析马尔可夫模型。我们使用了社会的角度和终身时间范围来估计成本和效果。进行单向敏感性分析和概率敏感性分析，以测试模型的稳健性。结果单位单击手术模型作为INPH中的标准治疗导致2.2岁生命年份和1.7质量调整的生命年份（QALY），以及每位患者的增量成本？7,500 / QALY。敏感性分析表明，结果对不确定参数或假设的变化不敏感。结论分流手术inph，一个欠老年患者严重损害的病情，不仅是一种有效的医疗，它也是成本效益，加入2.2额外的寿命和1.7 QALYS以低成本，为一个人的个人而言70？年。

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