Van Bergen Saskia H, Verhoeven Jorrit G, Kakar Ellaha, Jeekel Johannes, Birnie Erwin, Klimek Markus
Department of Surgery and Intensive Care Unit, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Department of Neuroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
J Surg Res. 2025 Jan;305:47-55. doi: 10.1016/j.jss.2024.10.052. Epub 2024 Dec 6.
Randomized controlled trials and meta-analyses have provided evidence of the positive effects of perioperative music interventions on pain, anxiety, and stress. However, the cost-effectiveness is unknown. The objective of this study was to analyze the cost-effectiveness of the implementation of a music intervention in the perioperative care of patients undergoing colorectal surgery.
A post hoc analysis was performed on patients included in the Implementation of Music Intervention in the PeRiOperatiVe standard care study: a clinical implementation study comparing the effects of perioperative music interventions (post-implementation group, N = 50) to standard care in colorectal surgery (pre-implementation group, N = 50). Main outcomes analyzed were postoperative pain scores and healthcare costs. Propensity score matching with inverse probability weighting was applied. Incremental costs and cumulative pain score differences were estimated using bootstrap analysis with 1000 replications.
Median age of the entire patient population was 62.5. Mean sum of postoperative pain scores on postoperative days 0 to 3 was 9.8 (range 0-40) (95% confidence interval [CI] 8.3-11.4) and 9.9 (95% CI; 7.0-12.9) in the pre- and post-implementation group, respectively (P = 0.970). The total costs were not significantly different between the pre- and post-implementation group in the entire group (€7000 versus €8,070, mean difference of €1070 (bootstrap 95% CI - €1190 - €3336), P = 0.353). Incremental costs were €1288 and €5030 (intention-to-treat and per protocol analysis, respectively) per clinically relevant decrease in pain during postoperative day 0-3.
The implementation of music intervention does not lead to a significant difference in costs. These results can aid clinicians considering the implementation of perioperative music.
随机对照试验和荟萃分析已提供证据表明围手术期音乐干预对疼痛、焦虑和压力有积极影响。然而，其成本效益尚不清楚。本研究的目的是分析在接受结直肠手术患者的围手术期护理中实施音乐干预的成本效益。
对纳入围手术期标准护理中音乐干预实施研究的患者进行事后分析：一项临床实施研究，比较围手术期音乐干预（实施后组，N = 50）与结直肠手术标准护理（实施前组，N = 50）的效果。分析的主要结局是术后疼痛评分和医疗费用。应用倾向得分匹配和逆概率加权法。使用1000次重复的自抽样分析估计增量成本和累积疼痛评分差异。
整个患者群体的中位年龄为62.5岁。实施前组和实施后组术后第０至3天术后疼痛评分的平均总和分别为9.8（范围0 - 40）（95%置信区间[CI] 8.3 - 11.4）和9.9（95% CI；7.0 - 12.9）（P = 0.970）。整个组中实施前组和实施后组的总成本无显著差异（7000欧元对8070欧元，平均差异1070欧元（自抽样95% CI - 1190欧元 - 3336欧元），P = 0.353）。术后第０至3天疼痛每临床相关降低一次，增量成本分别为1288欧元和5030欧元（意向性分析和符合方案分析）。
音乐干预的实施不会导致成本有显著差异。这些结果可为考虑实施围手术期音乐的临床医生提供帮助。
