Department of Neurology and Cerebrovascular Center (S.-E.K., J.Y.K., K.-J.L, J.K., B.J.K, M.-K.H., H.-J.B) and Department of Clinical Preventive Medicine (H.L.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; Department of Neurology (K.-H.C, J.-T.K.), Chonnam National University Hospital, Gwangju; Department of Neurology (D.-I.S., M.-J.Y.), Chungbuk National University Hospital, Cheongju; Department of Neurology (J.-K.C., D.-H.K., H.-W.N.), Dong-A University Hospital, Dong-A University College of Medicine, Busan; Department of Neurology (D.-E.K., W.-S.R.), Dongguk University Ilsan Hospital, Goyang; Department of Neurology (J.-M.P., K.K.), Eulji General Hospital, Seoul; Department of Neurology (J.-G.K., S.J.L.), Eulji University Hospital, Eulji University, Daejeon; Department of Neurology (M.-S.O., K.-H.Y., B.-C.L.), Hallym University Sacred Heart Hospital, Anyang; Department of Neurology (H.-K.P., K.-S.H., Y.-J.C.), Ilsan Paik Hospital, Inje University, Goyang; Department of Neurology (J.C.C.), Jeju National University Hospital, Jeju National University School of Medicine; Department of Neurology (S.I.S., J.-H.H.), Keimyung University Dongsan Medical Center, Daegu; Department of Neurology (M.-S.P., T.H.P., S.-S.P.), Seoul Medical Center; Department of Neurology (K.B.L.), Soonchunhyang University Hospital, College of Medicine, Seoul; Department of Neurology (J.-H.K., W.-J.K.), Ulsan University Hospital, Ulsan University College of Medicine; Department of Neurology (Jun Lee), Yeungnam University Hospital, Daegu; Clinical Research Center (J.S.L.), Asan Medical Center; Department of Biostatistics (Juneyoung Lee), Korea University College of Medicine, Seoul, Republic of Korea; Department of Neurology (A.M.), Helsinki University Central Hospital, Finland; and Davee Department of Neurology (P.B.G.), Northwestern University Feinberg School of Medicine, Chicago, IL.
Neurology. 2020 Mar 3;94(9):e978-e991. doi: 10.1212/WNL.0000000000009034. Epub 2020 Feb 6.
Stroke is a devastating and costly disease; however, there is a paucity of information on long-term costs and on how they differ according to 3-month modified Rankin scale (mRS) score, which is a primary outcome variable in acute stroke intervention trials.
We analyzed a prospective multicenter stroke registry (Clinical Research Collaboration for Stroke in Korea) database through linkage with claims data from the National Health Insurance Service with follow-up to December 2016. Healthcare expenditures were converted into daily cost individually, and annual and cumulative costs up to 5 years were estimated and compared according to the 3-month mRS score.
Between January 2011 and November 2013, 11,136 patients were enrolled in the study. The mean age was 68 years, and 58% were men. The median follow-up period was 3.9 years (range 0-5 years). Mean cumulative cost over 5 years was $117,576 (US dollars [USD]); the cost in the first year after stroke was the highest ($38,152 USD), which increased markedly from the cost a year before stroke ($8,718 USD). The mean 5-year cumulative costs differed significantly according to the 3-month mRS score ( < 0.001); the costs for a 3-month mRS score of 0 or 5 were $53,578 and $257,486 USD, respectively. Three-month mRS score was an independent determinant of long-term costs after stroke.
We show that 3-month mRS score plays an important role in the prediction of long-term costs after stroke. Such estimates relating to 3-month mRS categories may be valuable when undertaking health economic evaluations related to stroke care.
中风是一种破坏性和代价高昂的疾病；然而，关于长期成本以及它们如何根据 3 个月改良 Rankin 量表（mRS）评分（急性中风干预试验的主要结局变量）而有所不同的信息很少。
我们通过与国民健康保险服务索赔数据的链接，对前瞻性多中心中风登记处（韩国中风临床研究合作组织）数据库进行了分析，随访至 2016 年 12 月。将医疗保健支出单独转换为每日成本，并根据 3 个月 mRS 评分估算和比较 5 年内的年度和累计成本。
2011 年 1 月至 2013 年 11 月期间，共有 11136 名患者入组。患者的平均年龄为 68 岁，58%为男性。中位随访期为 3.9 年（0-5 年）。5 年内的累计平均成本为 117576 美元；中风后第一年的成本最高（38152 美元），比中风前一年（8718 美元）显著增加。根据 3 个月 mRS 评分，5 年累计成本差异有统计学意义（<0.001）；3 个月 mRS 评分为 0 或 5 的患者的 5 年累计成本分别为 53578 美元和 257486 美元。3 个月 mRS 评分是中风后长期成本的独立决定因素。
我们表明，3 个月 mRS 评分在预测中风后长期成本方面发挥着重要作用。在进行与中风护理相关的健康经济评估时，与 3 个月 mRS 类别相关的此类估计可能具有价值。
