Department of Neurosurgery, University of Louisville, 200 Abraham Flexner Hwy, Louisville, KY 40202, United States; Department of Neurosurgery, University of Minnesota, MMC 96, 420 Delaware St. SE, Minneapolis, MN 55455, United States.
Department of Neurosurgery, University of Louisville, 200 Abraham Flexner Hwy, Louisville, KY 40202, United States.
J Clin Neurosci. 2023 May;111:86-90. doi: 10.1016/j.jocn.2023.03.009. Epub 2023 Mar 27.
Intraoperative magnetic resonance imaging (iMRI) use in transsphenoidal approach (TSA) for pituitary tumors (PTs) has been reported to improve the extent of resection (EOR). The aim of this study is to report the trends and the impact of iMRI on healthcare utilization in patients who underwent TSA for PTs.
MarketScan database were queried using the ICD-9/10 and CPT-4, from 2004 to 2020. We included patients ≥ 18 years of age PTs with > 1 year follow-up. Outcomes were length of stay (LOS), discharge disposition, hospital/emergency room (ER) re-admissions, outpatient services, medication refills and corresponding payments.
A cohort of 10,192 patients were identified from the database, of these 141 patients (1.4%) had iMRI used during the procedure. Use of iMRI for PTs remained stable (2004-2007: 0.85%; 2008-2011: 1.6%; 2012-2015:1.4% and 2016-2019: 1.46%). No differences in LOS (median 3 days each), discharge to home (93% vs. 94%), complication rates (7% vs. 13%) and payments ($34604 vs. $33050) at index hospitalization were noted. Post-discharge payments were not significantly different without and with iMRI use at 6-months ($8315 vs. $ 7577, p = 0.7) and 1-year ($13,654 vs. $ 14,054, p = 0.70), following the index procedure.
iMRI use during TSA for PTs remained stable with no impact on LOS, complications, discharge disposition and index payments. Also, there was no difference in combined index payments at 6-months, and 1-year after the index procedure in patients with and without iMRI use for PTs.
术中磁共振成像（iMRI）在经蝶窦入路（TSA）治疗垂体瘤（PTs）中的应用已被报道可提高肿瘤全切除率（EOR）。本研究旨在报告 iMRI 在接受 TSA 治疗 PTs 的患者中的使用趋势及其对医疗保健利用的影响。
使用 ICD-9/10 和 CPT-4 从 2004 年至 2020 年在 MarketScan 数据库中进行查询。我们纳入了随访时间大于 1 年的年龄大于 18 岁的 PTs 患者。结果包括住院时间（LOS）、出院去向、医院/急诊室（ER）再入院、门诊服务、药物续配和相应的支付。
从数据库中确定了 10192 例患者的队列，其中 141 例（1.4%）在手术过程中使用了 iMRI。PTs 中 iMRI 的使用保持稳定（2004-2007 年：0.85%；2008-2011 年：1.6%；2012-2015 年：1.4%和 2016-2019 年：1.46%）。住院期间的 LOS（中位数各为 3 天）、出院回家（93%与 94%）、并发症发生率（7%与 13%）和支付（34604 美元与 33050 美元）没有差异。在索引手术后 6 个月（8315 美元与 7577 美元，p=0.7）和 1 年（13654 美元与 14054 美元，p=0.70），没有 iMRI 与有 iMRI 应用的患者的出院后支付没有显著差异。
PTs 经 TSA 中 iMRI 的使用保持稳定，对 LOS、并发症、出院去向和指数支付没有影响。此外，在有 iMRI 与无 iMRI 应用的患者中，在索引手术后 6 个月和 1 年的综合指数支付也没有差异。
