Abstract

MAYO, M. et al. Cost-effectiveness study of medullary electrostimulation for the management of refractory angina. Rev. Soc. Esp. Dolor [online]. 2004, vol.11, n.5, pp.282-286. ISSN 1134-8046.

Objective: To assess the evolution of patients in our hospital with diagnosis of refractory angina treated with cervical medul-lary electrostimulation (MES) over the period 1994-2002, and to determine the costs associated to this treatment and its cost-benefit ratio. Material and methods: Retrospective study including 12 patients that were fol-lowed-up for 8 years with regular clinical exams in order to determine, both before and after the implant, the following variables: left ventricle ejection fraction (LVEF), NYHA functional stage, frequency of hospitalization, frequency of angina episodes and cafinitrina‚ administration, subjective perception of angina pain relief, exitus, hospital costs before and after the placement of EMS. Results: The MES electrode was implanted at the cervical level, being C2-C3 the most frequent location (58.3%). There were no intra-operative complications. In the early post-operative, there was only one complication due to the displacement of the electrode. Neither there were long-term complications. We found a decrease in the number of anginas per week (14 vs 4, p = 0.005) associated to a decrease in the number of fast-action nitroglycerin doses (15.7 vs 3.8, p=0.002) and a decrease in the number of hospital admissions per year (2.62 vs 0.84, p=0.003). Subjective improvement as perceived by the patient after the placement of the neuro-stimulator was 70%. The five-year hospital costs (considering only the hospitalization costs, without any other further tests) was 37,921.85 € for patients with refractory angina without MES, compared to 15.150,25 e for patients with MES.

Keywords : Medullary electrostimulation; Angina; Costs.

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