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首页> 外文期刊>Stroke: A Journal of Cerebral Circulation >Cost-effectiveness of intravenous thrombolysis with alteplase within a 3-hour window after acute ischemic stroke.
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Cost-effectiveness of intravenous thrombolysis with alteplase within a 3-hour window after acute ischemic stroke.

机译：急性缺血性中风后3小时内使用阿替普酶静脉溶栓治疗的成本效益。

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摘要

BACKGROUND AND PURPOSE: The aim of this study was to assess the costs and cost-effectiveness of intravenous thrombolysis treatment with alteplase (Actilyse) of acute ischemic stroke with 24-hour in-house neurology coverage and use of magnetic resonance imaging. METHODS: A health economic model was designed to calculate the marginal cost-effectiveness ratios for time spans of 1, 2, 3 and 30 years. Effect data were extracted from a meta-analysis of six large-scale randomized and placebo-controlled studies of thrombolytic therapy with alteplase. Cost data were extracted from thrombolysis treatment at Aarhus Hospital, Denmark, and from previously published literature. RESULTS: The calculated cost-effectiveness ratio after the first year was Dollars 55,591 US per quality-adjusted life-year (base case). After the second year, computation of the cost-effectiveness ratio showed that thrombolysis was cost-effective. The long-term computations (30 years) showed that thrombolysis was a dominant strategy compared with conservative treatment given the model premises. CONCLUSIONS: A high-quality thrombolysis treatment with 24-hour in-house neurology coverage and magnetic resonance imaging might not be cost-effective in the short term compared with conservative treatment. In the long term, there are potentially large-scale health economic cost savings.
机译：背景与目的：这项研究的目的是评估急性缺血性卒中的阿替普酶（Actilyse）静脉溶栓治疗的费用和成本效益，并在室内进行24小时内部神经系统检查并使用磁共振成像。方法：设计了卫生经济模型来计算1、2、3和30年时间的边际成本效益比。从六项大规模的随机和安慰剂对照的阿替普酶溶栓治疗研究的荟萃分析中提取疗效数据。费用数据是从丹麦奥尔胡斯医院的溶栓治疗和以前发表的文献中提取的。结果：第一年后计算的成本效益比为每质量调整生命年（基础案例）55,591美元。第二年后，成本效益比的计算表明溶栓治疗具有成本效益。长期计算（30年）显示，与给定模型前提的保守治疗相比，溶栓是主要策略。结论：与保守治疗相比，短期内采用24小时内部神经病学覆盖和磁共振成像的高质量溶栓治疗可能并不划算。从长远来看，可以潜在地大规模节省卫生经济成本。

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