gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Article

Send article

Projected financial impact of chronic subdural haematoma surgical management in 2030 – Heading towards a crisis?

Voraussichtliche finanzielle Auswirkung des chirurgischen Managements chronisch Subduralhämatome in 2030: auf dem Weg in eine Krise?

Meeting Abstract

Search Medline for

  • presenting/speaker Mehdi Chihi - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Thiemo F. Dinger - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Marvin Darkwah Oppong - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Oliver Gembruch - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Yahya Ahmadipour - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Witold X. Chmielewski - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Laurèl Rauschenbach - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Alejandro Nicolas Santos - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Ulrich Sure - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Ramazan Jabbarli - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV290

doi: 10.3205/22dgnc281, urn:nbn:de:0183-22dgnc2818

Published: May 25, 2022

© 2022 Chihi et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Chronic subdural hematoma (cSDH) is a common disease of the elderly, increasing in incidence. Nowadays, crucial outcome-based factors as rates of recurrence requiring re-operation (RrR) and postoperative morbidity remain alarmingly high. Because of the demographic change, the financial impact of cSDH surgery on health systems could be outrageous. The aim of this study was to assess hospital charges of cSDH surgery and estimate their increase in 2030.

Methods: All patients with cSDH who were surgically treated at the authors' own institution between January 1st, 2007, and December 31st, 2017, were included. These cases were searched using the ICD-10 Code I62.02. Patient clinical complexity level (PCCL) was reported. All charges were adjusted to €2021 using inflation statistics.

Results: Altogether, 728 patients were included. RrR was observed in 18.1% (n=132), and a PCCL ≥3 in 44.5% (n=324) of the patients. Comparing the study year 2017 with 2007, there was a statistically significant increase in the incidence of surgically treated cSDH (91 vs. 34 patients/year), in patients' mean age (77.2 ± 9 years vs. 71.8 ± 11, p=0.005), in the proportion of old patients (≥65 years) (90.1% vs. 76.5%, p=0.005), in the length of stay on the intensive care unit (1.6 ± 4.5 vs. 0.5 ± 1 days, p=0.042), and in the yearly inflation-adjusted hospital charges (€844,713.04 vs. €240,929.15), especially in the cohort of old patients (p=0.025). By 2030, the mean cost per patient was estimated to reach €12,369.05 vs. €7,086.18 in 2007, i.e., €1,629,631.61/year.

Conclusion: Funding of cSDH surgical treatment must be considered an imperative challenge in the future neurosurgical practice. The lack of understanding of the disease's pathophysiology and complexity has led to a stagnation of poor outcomes of an aging population with expanding morbidity. Innovations in the medical treatment of cSDH are urgently needed to face this issue.