Comparative Cost Analysis for the Surgical and Endovascular Treatment of Ruptured Intracranial Aneurysms in Taiwan: A Nationwide Population-Based Cohort Study

Jian Han Chen, Chih Yuan Huang, Yi Che Lee, Kuo Wei Wang, Po Chou Liliang, Cheng Loong Liang, Kang Lu, Han Jung Chen, Yuan Ting Sun, Hao kuang Wang

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Abstract

Objective: Using a database that enabled longitudinal follow-up, we assessed the cost, outcome, complications, and readmission rate of ruptured cerebral aneurysms repaired by surgical clipping and endovascular coiling. Methods: This study was a retrospective review of data from a series of patients who underwent surgical clipping or endovascular coiling of ruptured cerebral aneurysms between 1996 and 2013. The medical records and hospital cost data were all examined. Results: A total of 7690 and 1380 cases were treated with clipping and coiling, respectively. Patients treated with clipping had more comorbidities and were older. The average total cost for endovascular coiling was $13,974.3, whereas the average total cost for surgical clipping was $16,581.7. Perioperative (30-day) mortality was 10.7% in patients with coiled aneurysms, compared with 12.6% in those with clipped aneurysms (P = 0.045). After 1 year of follow-up, clipping was associated with a significantly longer length of hospital stay (P < 0.001) and significantly higher total hospital costs (P < 0.001). Conclusions: In Taiwan, the total hospital costs for the surgical clipping of cerebral aneurysms were higher than for endovascular coiling, and the surgical results were associated with significant complications. We suggest that the indications for coiling might need to be expanded from the current standards dictated by the guidelines in Taiwan.

Original languageEnglish
Pages (from-to)e485-e490
JournalWorld Neurosurgery
Volume116
DOIs
Publication statusPublished - 2018 Aug

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Chen, Jian Han ; Huang, Chih Yuan ; Lee, Yi Che ; Wang, Kuo Wei ; Liliang, Po Chou ; Liang, Cheng Loong ; Lu, Kang ; Chen, Han Jung ; Sun, Yuan Ting ; Wang, Hao kuang. / Comparative Cost Analysis for the Surgical and Endovascular Treatment of Ruptured Intracranial Aneurysms in Taiwan : A Nationwide Population-Based Cohort Study. In: World Neurosurgery. 2018 ; Vol. 116. pp. e485-e490.