Early cost-utility estimation of the surgical correction of pectus excavatum with the Nuss bar

Wietse P. Zuidema, Jan W.A. Oosterhuis, Stefan M. Van Der Heide, Gerda W. Zijp, Robertine Van Baren, Alida F.W. Van Der Steeg, Ernst L.W.E. Van Heurn

Onderzoeksoutput: Bijdrage aan tijdschriftArtikelpeer review


OBJECTIVES The surgical correction of pectus excavatum (PE) with a Nuss bar provides satisfactory outcomes, but its cost-effectiveness is yet unproven. We prospectively analysed early outcomes and costs for Nuss bar placement. METHODS Fifty-four patients aged 16 years or older (6 females and 48 males; mean age, 17.9 years; range 16.0-29.4 years) with a PE filled out a Short Form-36 Health Survey (SF-6D) preoperatively and 1 year after a Nuss procedure. Costs included professional fees and fees for the operating room, materials and hospital care. Changes in the responses to the SF-36 or its domains were compared using the Wilcoxon signed rank test and the utility test results were calculated preoperatively and postoperatively from the SF-6D. The quality-adjusted life years (QALYs) were calculated from the results of these tests. RESULTS Significant improvements in physical functioning, social functioning, mental health and health transition (all P < 0.05) were noted. The other SF-36 subgroups showed improvement; however, the improvement was not significant. The SF-6D utility showed improvement from 0.76 preoperatively to 0.79 at the 1-year follow-up (P = 0.096). The mean direct costs were €8805. The 1-year discounted QALY gain was 0.03. The estimated cost-utility ratio was €293 500 per QALY gained. CONCLUSIONS Despite a significant improvement in many domains of the SF-36, the results of the SF-6D cost-utility analysis showed only a small improvement in cost-effectiveness (> €80 000/QALY) for patients with PE 1 year after Nuss bar placement. Based on this discrepancy, general health outcome measurements as the basis for cost-utility analysis in patients with PE may not be the best way forward.

Originele taal-2Engels
Pagina's (van-tot)699-703
Aantal pagina's5
TijdschriftEuropean Journal of Cardio-thoracic Surgery
Nummer van het tijdschrift4
StatusGepubliceerd - 1 apr. 2019
Extern gepubliceerdJa


Duik in de onderzoeksthema's van 'Early cost-utility estimation of the surgical correction of pectus excavatum with the Nuss bar'. Samen vormen ze een unieke vingerafdruk.

Citeer dit