Department of Anesthesiology, Boston University Medical Center, Boston, Massachusetts, USA.
AJNR Am J Neuroradiol. 2011 Aug;32(7):1290-4. doi: 10.3174/ajnr.A2502. Epub 2011 May 5.
Previous studies evaluating vertebral augmentation procedure costs have not made detailed comparisons between vertebroplasty and kyphoplasty. Our study contrasts hospital costs for vertebroplasty versus kyphoplasty for the treatment of vertebral compression fractures in routine clinical practice in the United States.
This retrospective cohort study analyzed 2007-2008 hospital discharge and billing records from the Premier Perspective data base. The primary outcome variable, differences in total hospital cost between vertebroplasty and kyphoplasty, was assessed by using analysis of covariance.
Three thousand six hundred seventeen patients received vertebroplasty (64% inpatient, 36% outpatient), and 8118 received kyphoplasty (54% inpatient, 46% outpatient). Approximately 75% were women, and most were white. Mean total unadjusted inpatient costs were $9837 for vertebroplasty versus $13 187 for kyphoplasty (P < .0001). Outpatient vertebroplasty costs were $3319 versus $8100 for kyphoplasty (P < .0001). Lower vertebroplasty costs were largely due to differences in hospital supply and OR. Mean vertebroplasty OR costs were $73.60 (anesthesia), $112.06 (recovery room), and $990.12 (surgery) versus $172.16 (anesthesia), $257.47 (recovery room), and $1,471.49 (surgery) with kyphoplasty. Adjustments for age, sex, admission status, and disease severity accentuated the differences. Mean adjusted inpatient costs were $11 386 for vertebroplasty versus $16 182 for kyphoplasty (P < .0001), and outpatient costs were $2997 for vertebroplasty versus $7010 for kyphoplasty (P < .0001). After adjustments for the same covariates, length-of-stay differences were no longer evident (P = .4945).
Performing vertebroplasty versus kyphoplasty reduces hospital costs by nearly $5000 for inpatient procedures and by more than $4000 for outpatient procedures.
既往评估椎体强化术费用的研究并未对椎体成形术和椎体后凸成形术进行详细比较。本研究对比了美国常规临床实践中治疗椎体压缩性骨折时椎体成形术和椎体后凸成形术的住院费用。
本回顾性队列研究分析了 2007 年至 2008 年 Premier Perspective 数据库的住院和计费记录。采用协方差分析比较椎体成形术和椎体后凸成形术的总住院费用差异，作为主要结局变量。
3617 例患者接受了椎体成形术（64%为住院患者，36%为门诊患者），8118 例患者接受了椎体后凸成形术（54%为住院患者，46%为门诊患者）。约 75%为女性，大多数为白人。未经调整的平均总住院费用为椎体成形术 9837 美元，椎体后凸成形术 13187 美元（P＜0.0001）。门诊椎体成形术费用为 3319 美元，椎体后凸成形术费用为 8100 美元（P＜0.0001）。椎体成形术费用较低主要是由于医院供应和手术室的差异。椎体成形术的平均手术室费用为 73.60 美元（麻醉）、112.06 美元（恢复室）和 990.12 美元（手术室），而椎体后凸成形术为 172.16 美元（麻醉）、257.47 美元（恢复室）和 1471.49 美元（手术室）。调整年龄、性别、入院状态和疾病严重程度后，差异更加明显。调整后的平均住院费用为椎体成形术 11386 美元，椎体后凸成形术 16182 美元（P＜0.0001），门诊费用为椎体成形术 2997 美元，椎体后凸成形术 7010 美元（P＜0.0001）。调整相同协变量后，住院时间差异不再明显（P=0.4945）。
与椎体后凸成形术相比，椎体成形术可使住院治疗的费用降低近 5000 美元，门诊治疗的费用降低 4000 多美元。
