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      COSTS ANALYSIS OF SPINAL COLUMN METASTASES SURGICAL TREATMENT Translated title: ANÁLISE DOS CUSTOS DO TRATAMENTO CIRÚRGICO DAS METÁSTASES DA COLUNA VERTEBRAL

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          ABSTRACT

          Introduction

          End-of-life cancer treatment is associated with substantial healthcare costs.

          Objective

          This study aimed to analyze the surgical treatment cost of spinal metastasis and epidural compression patients undergoing surgical treatment.

          Methods

          A retrospective cost analysis of 81 patients with spinal metastasis and epidural compression undergoing surgical treatment. Cost evaluation was defined in the following categories: medications, laboratory and imaging tests, nursery, recovery room, intensive care unit, surgical procedure, and consigned material. The cost of pain improvement, functional activity, and survival was also evaluated.

          Results

          The total cost of surgical treatment for 81 patients was $3,604,334.26, and the average value for each patient was $44,497.95. The highest costs were related to implants (41.1%), followed by hospitalization (27.3%) and surgical procedure (19.7%).

          Conclusion

          The cost of surgical treatment for spinal metastases is one of the most expensive bone complications in cancer patients. The cost of treatment related to outcomes showed differences according to the outcome analyzed. Hospital stay, tests, drugs, and intensive care play an important role in some of the costs related to the specific outcome. Level of Evidence II, Retrospective Study .

          RESUMO

          Introdução

          O tratamento do câncer em fim de vida está associado a custos substanciais em saúde.

          Objetivo

          O objetivo do estudo foi analisar o custo do tratamento cirúrgico de pacientes com metástase espinhal e compressão peridural submetidos ao tratamento cirúrgico.

          Métodos

          Uma análise retrospectiva de custos de 81 pacientes com metástase espinhal e compressão peridural submetidos a tratamento cirúrgico. A avaliação de custos foi definida nas seguintes categorias: medicamentos, exames laboratoriais e de imagem, enfermaria, sala de recuperação, unidade de terapia intensiva, procedimento cirúrgico e material consignado. O custo relacionado à melhora da dor, atividade funcional e sobrevida também foi avaliado.

          Resultados

          O custo total do tratamento cirúrgico de 81 pacientes foi de R $ 3.604.334,26 e o valor médio de cada paciente foi de R $ 44.497,95. Os maiores gastos foram relacionados com implantes (41,1%), seguidos de internação (27,3%) e procedimento cirúrgico (19,7%).

          Conclusão

          O custo do tratamento cirúrgico para metástases espinhais é um dos mais caros entre as complicações ósseas em pacientes com câncer. O custo do tratamento relacionado aos desfechos apresentou diferença de acordo com o desfecho analisado e a permanência hospitalar, exames, medicamentos e terapia intensiva tem papel importante em alguns dos custos relacionados ao desfecho específico. Nível de Evidência II, Estudo retrospectivo .

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          Most cited references24

          • Record: found
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          Metastasis to bone: causes, consequences and therapeutic opportunities.

          The most common human cancers --lung, breast and prostate -- have a great avidity for bone, leading to painful and untreatable consequences. What makes some cancers, but not others, metastasize to bone, and how do they alter its physiology? Some of the molecular mechanisms that are responsible have recently been identified, and provide new molecular targets for drug development.
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            Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial.

            The standard treatment for spinal cord compression caused by metastatic cancer is corticosteroids and radiotherapy. The role of surgery has not been established. We assessed the efficacy of direct decompressive surgery. In this randomised, multi-institutional, non-blinded trial, we randomly assigned patients with spinal cord compression caused by metastatic cancer to either surgery followed by radiotherapy (n=50) or radiotherapy alone (n=51). Radiotherapy for both treatment groups was given in ten 3 Gy fractions. The primary endpoint was the ability to walk. Secondary endpoints were urinary continence, muscle strength and functional status, the need for corticosteroids and opioid analgesics, and survival time. All analyses were by intention to treat. After an interim analysis the study was stopped because the criterion of a predetermined early stopping rule was met. Thus, 123 patients were assessed for eligibility before the study closed and 101 were randomised. Significantly more patients in the surgery group (42/50, 84%) than in the radiotherapy group (29/51, 57%) were able to walk after treatment (odds ratio 6.2 [95% CI 2.0-19.8] p=0.001). Patients treated with surgery also retained the ability to walk significantly longer than did those with radiotherapy alone (median 122 days vs 13 days, p=0.003). 32 patients entered the study unable to walk; significantly more patients in the surgery group regained the ability to walk than patients in the radiation group (10/16 [62%] vs 3/16 [19%], p=0.01). The need for corticosteroids and opioid analgesics was significantly reduced in the surgical group. Direct decompressive surgery plus postoperative radiotherapy is superior to treatment with radiotherapy alone for patients with spinal cord compression caused by metastatic cancer.
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              • Record: found
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              • Article: not found

              The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. I.

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                Author and article information

                Contributors
                Role: article designRole: statistical analysisRole: project design and writing
                Role: article designRole: statistical analysisRole: project design and writing
                Role: article designRole: writing and review
                Role: article designRole: writing and review
                Role: article designRole: writing and review
                Role: article designRole: project designRole: statistical analysisRole: writing and review
                Journal
                Acta Ortop Bras
                Acta Ortop Bras
                aop
                Acta Ortopedica Brasileira
                ATHA EDITORA
                1413-7852
                1809-4406
                02 December 2022
                2022
                : 30
                : spe2
                : e251579
                Affiliations
                [1 ]Universidade de São Paulo, Ribeirão Preto Medical School, Unimed-Limeira and Doctoral Student at Department of Medical Clinics, São Pulo, SP, Brazil.
                [2 ]Universidade de São Paulo, Ribeirão Preto Medical School, Division of Clinical Oncology, Department of Medical Images, Hematology and Clinical Oncology, São Paulo, SP, Brazil.
                [3 ]Universidade de São Paulo, Ribeirão Preto Medical School, Department of Social Medicine, São Paulo, SP, Brazil.
                Author notes
                Correspondence: Rômulo Pedroza Pinheiro. Universidade de São Paulo, Ribeirão Preto Medical School, Department of Orthopedics and Anesthesiology, Av. Bandeirantes 3900, Monte Alegre, Ribeirão Preto, SP-Brazil. romulopinheiro@ 123456usp.br

                All authors declare no potential conflict of interest related to this article.

                AUTHORS’ CONTRIBUTION: Each author contributed individually and significantly to the development of this article. ACS: data collection and review.

                Author information
                http://orcid.org/0000-0002-9386-3600
                http://orcid.org/0000-0002-3653-6259
                http://orcid.org/0000-0001-9934-920X
                http://orcid.org/0000-0002-0623-3003
                http://orcid.org/0000-0003-3965-6886
                http://orcid.org/0000-0003-4274-0130
                Article
                00208
                10.1590/1413-785220223002e251579
                9721407
                36506865
                b5162463-f409-4ef2-a8ec-0be769cd60d5

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 April 2021
                : 16 August 2021
                Page count
                Figures: 3, Tables: 6, Equations: 0, References: 21
                Categories
                Original Article
                Spine

                palliative care,spinal cord compression,hospital costs,costs and cost analysis,cuidados paliativos,compressão da medula espinal,custos hospitalares,custos e análise de custo

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