Erratum to ‘Cost differences between autologous and nonautologous cranioplasty implants: A propensity score–matched value driven outcomes analysis’ [World Neurosurgery: X (22C) (2024) (100358)]
Objective: Despite having higher rates of failure and revision than other implant materials, autologous bone implants are the historical gold standard for restoring cranial defects after decompressive hemicraniectomy. More reliable synthetic implants have been developed, but they are significantly m...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | World Neurosurgery: X |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590139724001558 |
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| author | Matthew Findlay Sawyer Z. Bauer Diwas Gautam Matthew Holdaway Robert B. Kim Walid K. Salah Spencer Twitchell Sarah T. Menacho Gurpreet S. Gandhoke Ramesh Grandhi |
| author_facet | Matthew Findlay Sawyer Z. Bauer Diwas Gautam Matthew Holdaway Robert B. Kim Walid K. Salah Spencer Twitchell Sarah T. Menacho Gurpreet S. Gandhoke Ramesh Grandhi |
| author_sort | Matthew Findlay |
| collection | DOAJ |
| description | Objective: Despite having higher rates of failure and revision than other implant materials, autologous bone implants are the historical gold standard for restoring cranial defects after decompressive hemicraniectomy. More reliable synthetic implants have been developed, but they are significantly more expensive than autologous bone. The authors sought to compare the initial and long-term costs of custom synthetic implants and autologous cranioplasty grafts. Methods: The authors reviewed the hospital billing records over a 12-year period at their institution to identify patients who underwent cranioplasty after decompressive hemicraniectomy for trauma or stroke. The costs for imaging, hospital supplies, implants, pharmacy services, facility usage, and laboratory studies were captured for initial surgeries and for subsequent cranioplasty-related revision hospitalizations and surgeries. Clinical characteristics, long-term outcomes, and cost differences of autologous versus custom implants were compared by using univariate and multivariate analyses. These analyses were repeated after propensity-score matching adjusted for factors predictive of cranioplasty failure. Results: On unmatched analysis, 32 custom and 128 autologous implants were analyzed. Differences in initial cranioplasty failure rates between custom and autologous grafts were insignificant (12.5 % custom vs. 23.4 % autologous, p = 0.18). On univariate analysis, autologous implants cost 46.8 % of custom grafts during the initial hospitalization period (p < 0.01) and 58.7 % of custom grafts once long-term aggregated costs were factored (p < 0.01). Upon multivariate analysis, although custom cranioplasty was independently predictive of higher initial hospitalization costs (standardized β = 0.20, p < 0.01), it was not predictive of long-term total aggregated costs (standardized β = 0.10, p = 0.13). After propensity score matching (29 custom, 29 autologous cases), multivariate analysis of the matched cohorts likewise found custom implants were predictive of greater initial hospitalization costs (standardized β = 0.56, p < 0.01), but were not an independent driver of aggregated long-term costs (standardized β = 0.22, p = 0.11). Conclusion: Our matched and unmatched multivariate analysis found nonsignificant cost differences between custom and autologous cranioplasties once initial and long-term costs were aggregated, suggesting custom implants could be considered as a primary therapeutic intervention. |
| format | Article |
| id | doaj-art-a414342ab31f4baaa9eac08bf5411547 |
| institution | Kabale University |
| issn | 2590-1397 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Neurosurgery: X |
| spelling | doaj-art-a414342ab31f4baaa9eac08bf54115472025-02-10T04:34:52ZengElsevierWorld Neurosurgery: X2590-13972025-01-0125100424Erratum to ‘Cost differences between autologous and nonautologous cranioplasty implants: A propensity score–matched value driven outcomes analysis’ [World Neurosurgery: X (22C) (2024) (100358)]Matthew Findlay0Sawyer Z. Bauer1Diwas Gautam2Matthew Holdaway3Robert B. Kim4Walid K. Salah5Spencer Twitchell6Sarah T. Menacho7Gurpreet S. Gandhoke8Ramesh Grandhi9School of Medicine, University of Utah, Salt Lake City, UT, USAReno School of Medicine, University of Nevada, Reno, NV, USASchool of Medicine, University of Utah, Salt Lake City, UT, USASchool of Medicine, University of Utah, Salt Lake City, UT, USADepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USADepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USADepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USADepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USADepartment of Surgery, University of Missouri Kansas City, Marion Bloch Neuroscience Institute, Saint Luke's Hospital of Kansas City, Kansas, MO, USADepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA; Corresponding author.Objective: Despite having higher rates of failure and revision than other implant materials, autologous bone implants are the historical gold standard for restoring cranial defects after decompressive hemicraniectomy. More reliable synthetic implants have been developed, but they are significantly more expensive than autologous bone. The authors sought to compare the initial and long-term costs of custom synthetic implants and autologous cranioplasty grafts. Methods: The authors reviewed the hospital billing records over a 12-year period at their institution to identify patients who underwent cranioplasty after decompressive hemicraniectomy for trauma or stroke. The costs for imaging, hospital supplies, implants, pharmacy services, facility usage, and laboratory studies were captured for initial surgeries and for subsequent cranioplasty-related revision hospitalizations and surgeries. Clinical characteristics, long-term outcomes, and cost differences of autologous versus custom implants were compared by using univariate and multivariate analyses. These analyses were repeated after propensity-score matching adjusted for factors predictive of cranioplasty failure. Results: On unmatched analysis, 32 custom and 128 autologous implants were analyzed. Differences in initial cranioplasty failure rates between custom and autologous grafts were insignificant (12.5 % custom vs. 23.4 % autologous, p = 0.18). On univariate analysis, autologous implants cost 46.8 % of custom grafts during the initial hospitalization period (p < 0.01) and 58.7 % of custom grafts once long-term aggregated costs were factored (p < 0.01). Upon multivariate analysis, although custom cranioplasty was independently predictive of higher initial hospitalization costs (standardized β = 0.20, p < 0.01), it was not predictive of long-term total aggregated costs (standardized β = 0.10, p = 0.13). After propensity score matching (29 custom, 29 autologous cases), multivariate analysis of the matched cohorts likewise found custom implants were predictive of greater initial hospitalization costs (standardized β = 0.56, p < 0.01), but were not an independent driver of aggregated long-term costs (standardized β = 0.22, p = 0.11). Conclusion: Our matched and unmatched multivariate analysis found nonsignificant cost differences between custom and autologous cranioplasties once initial and long-term costs were aggregated, suggesting custom implants could be considered as a primary therapeutic intervention.http://www.sciencedirect.com/science/article/pii/S2590139724001558 |
| spellingShingle | Matthew Findlay Sawyer Z. Bauer Diwas Gautam Matthew Holdaway Robert B. Kim Walid K. Salah Spencer Twitchell Sarah T. Menacho Gurpreet S. Gandhoke Ramesh Grandhi Erratum to ‘Cost differences between autologous and nonautologous cranioplasty implants: A propensity score–matched value driven outcomes analysis’ [World Neurosurgery: X (22C) (2024) (100358)] World Neurosurgery: X |
| title | Erratum to ‘Cost differences between autologous and nonautologous cranioplasty implants: A propensity score–matched value driven outcomes analysis’ [World Neurosurgery: X (22C) (2024) (100358)] |
| title_full | Erratum to ‘Cost differences between autologous and nonautologous cranioplasty implants: A propensity score–matched value driven outcomes analysis’ [World Neurosurgery: X (22C) (2024) (100358)] |
| title_fullStr | Erratum to ‘Cost differences between autologous and nonautologous cranioplasty implants: A propensity score–matched value driven outcomes analysis’ [World Neurosurgery: X (22C) (2024) (100358)] |
| title_full_unstemmed | Erratum to ‘Cost differences between autologous and nonautologous cranioplasty implants: A propensity score–matched value driven outcomes analysis’ [World Neurosurgery: X (22C) (2024) (100358)] |
| title_short | Erratum to ‘Cost differences between autologous and nonautologous cranioplasty implants: A propensity score–matched value driven outcomes analysis’ [World Neurosurgery: X (22C) (2024) (100358)] |
| title_sort | erratum to cost differences between autologous and nonautologous cranioplasty implants a propensity score matched value driven outcomes analysis world neurosurgery x 22c 2024 100358 |
| url | http://www.sciencedirect.com/science/article/pii/S2590139724001558 |
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