Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain.
Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain.
J Stroke Cerebrovasc Dis. 2024 Nov;33(11):107906. doi: 10.1016/j.jstrokecerebrovasdis.2024.107906. Epub 2024 Aug 8.
Mechanical Thrombectomy (MT) is an efficacious treatment for severe acute ischemic stroke patients. However, access to MT is limited in many parts of the world, partly due to economic barriers. The purpose of this systematic review is to provide an updated frame about the socioeconomic impact of MT.
To carry out this systematic review we used the PRISMA guidelines. We included scientific articles analyzing the socioeconomic impact of MT for acute ischemic stroke, in which MT was compared to best medical therapy (BMT). The online databases of Pubmed, Scopus and Web of Science were used as main sources of information. To carry out the comparative analysis, the incremental cost-effectiveness ratio (ICER) was used, relating the cost to quality-adjusted life-year (QALY). Risk of bias was assessed with the Consensus Health Economic Criteria (CHEC) and the Consolidated Health Economic Evaluation Reporting Standards (CHEERS).
Eight hundred thirty-two studies were identified in this systematic review. As a result, studies that used cost-effectiveness analysis show that MT saves costs in the long term and cost-utility analysis show that the cost per QALY is reasonable with a mean ICER value of $14242.36/QALY.
MT has a favorable socioeconomic impact, as derived from cost-effectiveness and cost-utility analyses. Therefore, public policies should encourage the implementation of MT for stroke patients around the world.
机械血栓切除术（MT）是治疗严重急性缺血性脑卒中患者的有效方法。然而，在世界上许多地方，由于经济障碍，MT 的应用受到限制。本系统评价的目的是提供 MT 的社会经济影响的最新框架。
为了进行这项系统评价，我们使用了 PRISMA 指南。我们纳入了分析 MT 对急性缺血性脑卒中的社会经济影响的科学文章，其中 MT 与最佳药物治疗（BMT）进行了比较。我们主要从 Pubmed、Scopus 和 Web of Science 在线数据库中获取信息。为了进行比较分析，我们使用增量成本效益比（ICER），将成本与质量调整生命年（QALY）联系起来。我们使用共识健康经济标准（CHEC）和健康经济评估报告标准（CHEERS）评估偏倚风险。
在这项系统评价中，共确定了 832 项研究。结果表明，使用成本效益分析的研究表明，MT 在长期内可以节省成本，而成本效用分析表明，每 QALY 的成本是合理的，平均 ICER 值为 14242.36 美元/QALY。
MT 的成本效益和成本效用分析显示其具有有利的社会经济效益。因此，公共政策应该鼓励在世界各地为脑卒中患者实施 MT。
