Determinants of resource utilization in the treatment of brain arteriovenous malformations.

Determinants of resource utilization in the treatment of brain arteriovenous malformations. Research Abstract Details 

Research Abstract Table of Contents

Jump to the:

Determinants of resource utilization in the treatment of brain arteriovenous malformations. Abstract Text:

M F Berman,A Hartmann,H Mast,R R Sciacca,J P Mohr,J Pile-Spellman,W L Young,

BACKGROUND AND PURPOSE: Preoperative embolization of arteriovenous malformations (AVMs) is thought to improve outcome following surgical resection of these lesions. The purpose of this study was to examine the cost associated with preoperative embolization and different surgical risk categories in the surgical treatment of brain AVMs. METHODS: In a review of 126 patients treated surgically for resection of AVMs, we noted the total days spent in the hospital and calculated the associated costs (from hospital and estimated professional fees). Surgical risk category was determined using the Spetzler-Martin grading system. We examined the effect of risk category, preoperative embolization, and outcome (Rankin score) on cost and inpatient days. RESULTS: Preoperative embolization and greater surgical risk were independently associated with higher total costs. Average adjusted cost for embolization and surgery was $78,400 +/- $4,900 versus $49,300 +/- $5,800 for surgery alone. Patients ranged in preoperative risk category from Spetzler-Martin grades II through V, with an average increase of $20,100 in total cost per Spetzler-Martin grade (95% CI, $13,500 to $28,100). Higher surgical risk category was also associated with more days spent in hospital, with an average increase of 6 days per increment in Spetzler-Martin grade (95% CI, 4 to 8). After surgical resection of an AVM, new neurologic deficits were associated with large differences in cost: $68,500 +/- $6,100 and 15 +/- 2 days in hospital for patients who were neurologically worse after surgery, versus $44,700 +/- $3,900 and 10 +/- 1 days for patients who were unchanged. CONCLUSION: Preoperative embolization in the treatment of AVMs is associated with higher cost but not more days in the hospital. Patients with higher Spetzler-Martin grade AVMs utilize more hospital resources, in part because they have poorer neurologic outcome, and postoperative deficits are associated with higher costs and more days in the hospital.

Determinants of resource utilization in the treatment of brain arteriovenous malformations. Publishing Authors By Initials

MF Berman,A Hartmann,H Mast,RR Sciacca,JP Mohr,J Pile-Spellman,WL Young,

For similar diagnosis: prognosis research abstracts see: diagnosis: prognosis research

PUBMED ID PMID:

MEDLINE DATE:

Determinants of resource utilization in the treatment of brain arteriovenous malformations. Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: AJNR. American journal of neuroradiology

VOLUME: 20

Page Numbers: 2004-8

Journal Abbreviation:

ISSN: 0195-6108

DAY: 14

MONTH: 02

YEAR: 2008

Determinants of resource utilization in the treatment of brain arteriovenous malformations. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 8003708

Determinants of resource utilization in the treatment of brain arteriovenous malformations. Keywords Mesh Terms:

KEYWORDS: Prognosis

MESH TERMS: economics

Chemical & Substance for Abstract: Determinants of resource utilization in the treatment of brain arteriovenous malformations. Information

Substance Name:

Registry Number:

Grant and Affiliation Information for Determinants of resource utilization in the treatment of brain arteriovenous malformations.

AFFILIATION: Department of Anesthesiology, Columbia University College of Physicians & Surgeons, New York, NY, USA.

Country: UNITED STATES

AGENCY: United States NINDS

GRANT: NS34949

ACRONYM: NS

MEDLINETA: AJNR Am J Neuroradiol

REFSOURCE:

DATABASENAME:

ACCESSION NUMBER:

Number Hits: 0

Determinants of resource utilization in the treatment of brain arteriovenous malformations Related Publications

• A comparison of neural differentiation and retinal transplantation with bone marrow-derived cells and retinal progenitor cells.
• A national perspective of surgery in children with cerebral palsy.
• Adapting to artificial gravity (AG) at high rotational speeds.
• Anthrax toxin receptor 2-dependent lethal toxin killing in vivo.
• Assembly of multilayer films incorporating a viral protein cage architecture.
• Combating the epidemic of obesity and cardiovascular disease: perspectives from school-aged children.
• Concomitant use of modafinil and tranylcypromine in a patient with narcolepsy: a case report.
• Correlation of scrotal circumference and age in American Brahman bulls.
• Death by managed care-denial of hospitalization for headache.
• Dehiscent high jugular bulb: a pitfall in middle ear surgery.
• Developmental origins of obesity: a sympathoadrenal perspective.
• Dorsal cochlear nucleus response properties following acoustic trauma: response maps and spontaneous activity.
• Endoscopic management of hydrocephalus secondary to tumors of the posterior third ventricle.
• Examination of the food and nutrient content of school lunch menus of two school districts in Mississippi.
• Failure of gonadotropin-releasing hormone or human chorionic gonadotropin to enhance the fertility of repeat-breeder cows when administered at the time of insemination.
• Implementation of a cardiovascular disease prevention program among school-aged children: a pilot study.
• Interplay of circadian clocks and metabolic rhythms.
• Large recursive partitioning analysis of complex disease pharmacogenetic studies. II. Statistical considerations.
• Longer fixation duration while viewing face images.
• Loss of O-antigen increases cell shape abnormalities in penicillin-binding protein mutants of Escherichia coli.
• Molecular and statistical tools for circadian transcript profiling.
• Objectively measured physical activity in sixth-grade girls.
• Primate molecular divergence dates.
• Protein farnesyltransferase inhibitors and progeria.
• Simultaneous and concurrent polydrug use of alcohol and prescription drugs: prevalence, correlates, and consequences.
• Social effectiveness therapy for children: five years later.
• Story recall and narrative coherence of high-functioning children with autism spectrum disorders.
• Structure of the MAST with an Australian sample of alcoholics.
• Synthesis of (2S,4S)- and (2S,4R)-5-fluoroleucine and (2S,4S)-[5,5-2H2]-5-fluoroleucine.
• Vestibular evoked myogenic potentials in acute acoustic trauma.