RESUMO
INTRODUCTION: The increase in the indications for mechanical thrombectomy and its implementation in Spanish hospitals makes it necessary to determine the costs related to this treatment so as to be able to streamline economic resources and allow them to be distributed in an appropriate manner. AIMS: To analyse the direct costs associated with patients with acute ischaemic stroke who are treated with intravenous fibrinolysis and with mechanical thrombectomy, and to assess the effectiveness and safety of both treatments during the first 90 days of progression in the Hospital Universitario Central de Asturias. PATIENTS AND METHODS: A retrospective analysis was performed that included 44 patients who received intravenous fibrinolysis and 61 patients treated with mechanical thrombectomy, in whom a series of clinical and economic variables were analysed. RESULTS: The mean final total cost per patient was 16,059 euros in treatments with thrombectomy and 8,169 euros in those in which intravenous fibrinolysis was administered. The percentage of patients with a good functional prognosis at 90 days was 63.93% in those treated by endovascular means and 56.82% in those who received intravenous fibrinolysis. Mortality rates were 18.03 and 11.36%, respectively. CONCLUSIONS: The mean cost of treatment with mechanical thrombectomy, as well as the total mean cost per patient during the acute phase of the disease associated with this technique, is higher than in the case of intravenous fibrinolysis. In our setting, both intravenous fibrinolysis and mechanical thrombectomy are considered to be effective and safe.
TITLE: Analisis de los costes directos asociados a la trombectomia mecanica y a la fibrinolisis intravenosa en el Hospital Universitario Central de Asturias.Introduccion. La ampliacion de las indicaciones de la trombectomia mecanica y su implementacion en los hospitales españoles hacen necesario conocer los costes relacionados con este tratamiento para racionalizar los recursos economicos y permitir una adecuada distribucion de estos. Objetivos. Analizar los costes directos asociados a los pacientes con ictus isquemico agudo tratados con fibrinolisis intravenosa y con trombectomia mecanica, y valorar la efectividad y seguridad de ambos tratamientos durante los primeros 90 dias de evolucion en el Hospital Universitario Central de Asturias. Pacientes y metodos. Se realizo un analisis retrospectivo en el que se incluyo a 44 pacientes que recibieron fibrinolisis intravenosa y a 61 pacientes tratados con trombectomia mecanica, en los que se analizaron una serie de variables clinicas y economicas. Resultados. El coste total final medio por paciente fue de 16.059 euros en los tratados con trombectomia y de 8.169 euros en los que se administro fibrinolisis intravenosa. El porcentaje de pacientes con buen pronostico funcional a los 90 dias fue del 63,93% en los tratados de forma endovascular y del 56,82% en los que recibieron fibrinolisis intravenosa. Las tasas de mortalidad fueron del 18,03% y 11,36%, respectivamente. Conclusiones. El coste medio del tratamiento con trombectomia mecanica, asi como el coste medio total por paciente durante la fase aguda de la enfermedad asociado a esta tecnica, es mayor que en el caso de la fibrinolisis intravenosa. Tanto la fibrinolisis intravenosa como la trombectomia mecanica se configuran en nuestro medio como tratamientos efectivos y seguros.
