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Effect of patient age on glioblastoma perioperative treatment costs: a value driven outcome database analysis

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Abstract

Introduction

Identification of groups of patients or interventions with higher associated treatment costs may be beneficial in efforts to decrease the overall financial burden of glioblastoma (GBM) treatment. The authors’ objective was to evaluate perioperative surgical treatment cost differences between elderly and nonelderly patients with GBM using the Value Driven Outcome (VDO) database.

Methods

The authors obtained data from a retrospective cohort of GBM patients treated surgically (resection or biopsy) at their institution from August 2011 to February 2018. Data were compiled using medical records and the VDO database.

Results

A total of 181 patients with GBM were included. Patients were grouped into age < 70 years at time of surgery (nonelderly; n = 121) and ≥ 70 years (elderly; n = 60). Costs were approximately 38% higher in the elderly group on average (each patient was mean 0.68% of total cohort cost vs. 0.49%, p = 0.044). Higher age significantly, but weakly, correlated with higher treatment cost on linear regression analysis (p = 0.007; R2 = 0.04). Length of stay was significantly associated with increased cost on linear regression (p < 0.001, R2 = 0.84) and was significantly longer in the elderly group (8.7 ± 11.3 vs. 5.2 ± 4.3 days, p = 0.025). The cost breakdown by facility, pharmacy, supply/implants, imaging, and laboratory costs was not significantly different between age groups. Elderly patients with any postoperative complication had 2.1 times greater total costs than those without complication (p = 0.094), 2.9 times greater total costs than nonelderly patients with complication (p = 0.013), and 2.3 times greater total costs than nonelderly patients without complication (p = 0.022).

Conclusions

GBM surgical treatment costs are higher in older patients, particularly those who experience postoperative complications.

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Acknowledegements

We thank Kristin Kraus, MSc, for editorial assistance with this paper and Jacob Kresser for assistance with the VDO database.

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Authors and Affiliations

  1. Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 North Medical Drive East, Salt Lake City, UT, 84132, USA

    Brandon A. Sherrod, Nicholas T. Gamboa, Christopher Wilkerson, Herschel Wilde, Mohammed A. Azab, Michael Karsy, Randy L. Jensen & Sarah T. Menacho

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Sherrod, B.A., Gamboa, N.T., Wilkerson, C. et al. Effect of patient age on glioblastoma perioperative treatment costs: a value driven outcome database analysis. J Neurooncol 143, 465–473 (2019). https://doi.org/10.1007/s11060-019-03178-z

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