ArticleBMJ open2021
Cerebrospinal fluid leakage costs after craniotomy and health economic assessment of incidence reduction from a hospital perspective in the Netherlands.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05717335 (Observational Pilot Study With TachoSil as a Ventricular Sealant), which is not on this map. Cited by 10 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Observational Pilot Study With TachoSil as a Ventricular Sealant
Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Craniotomy versus craniectomy in posterior fossa tumor surgery: A systematic review and Meta-Analysis.Neurosurgical review · 2025Pooled it
- Efficacy and safety of endoscopic compared with open surgical repair of cerebrospinal fluid fistulas: a systematic review and meta-analysis.Neurosurgical review · 2025Pooled it
- Factors Influencing Cerebrospinal Fluid Leaking following Pituitary Adenoma Transsphenoidal Surgery: A Meta-Analysis and Comprehensive Review.BioMed research international · 2022Pooled it
- Safety and effectiveness of EvicelChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Trial
- Cost-effectiveness of laser interstitial thermal therapy vs. anterior temporal lobectomy for drug-resistant mesial temporal lobe epilepsy: A decision analytic model.Epilepsia open · 2026Article
- Effectiveness and safety of Tachosil® as a ventricular sealant: an observational cohort study.Acta neurochirurgica · 2024Observational
- PEG hydrogel sealant versus fibrin glue in posterior fossa surgery: an economic comparison across five European countries.Journal of comparative effectiveness research · 2024Article
- Cerebrospinal fluid leakage prevention using the anterior transpetrosal approach with versus without postoperative spinal drainage: an institutional cohort study.Neurosurgical review · 2023Article
- Cerebrospinal fluid leakage after intradural spinal surgery in children.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023Article
- Histological and magnetic resonance imaging assessment of Liqoseal in a spinal in vivo pig model.Animal models and experimental medicine · 2023Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe aim to quantify the cost difference between patients with incisional cerebrospinal fluid (iCSF) leakage and those without after intradural cranial surgery. Second, the potential cost savings per patient when a decrease in iCSF leakage rate would be achieved with and without added costs for preventative measures of various price and efficacy are modelled.
designHealth economic assessment from a hospital perspective based on a retrospective cohort study.
settingDutch tertiary referral centre.
participantsWe included 616 consecutive patients who underwent intradural cranial surgery between 1 September 2017 and 1 September 2018. Patients undergoing burr hole surgery or transsphenoidal surgery, or who died within 1 month after surgery or were lost to follow-up were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES: Outcomes of the cost analysis include a detailed breakdown of mean costs per patient for patients with postoperative iCSF leakage and patients without, and the mean cost difference. For the scenario analyses the outcomes are the potential cost savings per 1000 patients when a decrease in iCSF leakage would be achieved.
resultsMean cost difference between patients with and without iCSF leakage was €9665 (95%CI, €5125 to €14 205). The main cost driver was hospital stay with a difference of 8.5 days. A 25% incidence reduction would result in a mean cost saving of -€94 039 (95% CI, -€218 258 to -€7077) per 1000 patients. A maximum cost reduction of -€653 025 (95% CI, -€1 204 243 to -€169 120) per 1000 patients could be achieved if iCSF leakage would be reduced with 75% in all patients, with 72 cases of iCSF leakage avoided.
conclusionsPostoperative iCSF leakage after intradural cranial surgery increases healthcare costs significantly and substantially. From a health economic perspective preventative measures to avoid iCSF leakage should be pursued.
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