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Prostatic Artery Embolization Versus Transurethral Resection of the Prostate: A Post Hoc Cost Analysis of a Randomized Controlled Clinical Trial.
CardioVascular and Interventional Radiology ( IF 2.9 ) Pub Date : 2021-07-20 , DOI: 10.1007/s00270-021-02920-3
Ferran Capdevila 1, 2, 3 , Iñigo Insausti 1, 4 , Arkaitz Galbete 1, 2, 3, 5, 6 , Eduardo Sanchez-Iriso 2, 3 , Manuel Montesino 1, 2, 3
Affiliation  

PURPOSE To perform a post hoc analysis of patient-incurred costs in a randomized controlled clinical trial comparing prostatic artery embolization (PAE) and transurethral resection of the prostate (TURP). MATERIALS AND METHODS Patients older than 60 years with indication of TURP were randomized to PAE or TURP procedure. After intervention and hospital discharge, patients were follow-up during 12 months The associated patient costs were categorized according to the study period: pre-intervention, intervention, hospitalization, and follow-up. Several items for both groups were analyzed within each study period. RESULTS The mean total costs per patient were lower for PAE (€ 3,192.87) than for TURP (€ 3,974.57), with this difference of € 781.70 being significant (p = 0.026). For most evaluated items, the mean costs were significantly higher for TURP. No significant differences were observed in the mean costs of PAE (€ 1,468.00) and TURP (€ 1,684.25) procedures (p = 0.061). However, the histopathology analysis, recovery room stay, and intraoperative laboratory analysis increased the interventional costs for TURP (€ 1,999.70) compared with PAE (€ 1,468.00) (p < 0.001). No cost differences were observed between PAE (€ 725.26) and TURP (€ 556.22) during the 12 months of follow-up (p = 0.605). None of patients required a repeat intervention during the study period. CONCLUSIONS Considering the short-term follow-up, PAE was associated with significantly lower costs compared with TURP. Future investigations in the context of routine clinical practice should be aimed at comparing the long-term effectiveness of both procedures and determining their cost-effectiveness. LEVEL OF EVIDENCE Level 1 (a-c).

中文翻译:

前列腺动脉栓塞与经尿道前列腺切除术:随机对照临床试验的事后成本分析。

目的 在一项比较前列腺动脉栓塞术 (PAE) 和经尿道前列腺切除术 (TURP) 的随机对照临床试验中,对患者产生的费用进行事后分析。材料和方法 60 岁以上有 TURP 指征的患者随机接受 PAE 或 TURP 程序。干预和出院后,对患者进行 12 个月的随访。相关的患者费用根据研究期间进行分类:干预前、干预、住院和随访。在每个研究期间分析了两组的几个项目。结果 每名患者的平均总成本 PAE(3,192.87 欧元)低于 TURP(3,974.57 欧元),差异显着为 781.70 欧元(p = 0.026)。对于大多数评估项目,TURP 的平均成本明显更高。PAE(1,468.00 欧元)和 TURP(1,684.25 欧元)程序的平均成本没有显着差异(p = 0.061)。然而,与 PAE(1,468.00 欧元)相比,组织病理学分析、恢复室停留时间和术中实验室分析增加了 TURP(1,999.70 欧元)的介入成本(p < 0.001)。在 12 个月的随访期间,PAE(725.26 欧元)和 TURP(556.22 欧元)之间未观察到成本差异(p = 0.605)。在研究期间,没有患者需要重复干预。结论 考虑到短期随访,与 TURP 相比,PAE 的成本显着降低。未来在常规临床实践中的研究应旨在比较两种程序的长期有效性并确定其成本效益。
更新日期:2021-07-20
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