目的:手术和放射治疗(RT)患者的实践模式和对医疗保健利用的影响趋势尚不明确。
方法:使用ICD-9/10和CPT第4版查询了MarketScan数据库,2000-2020年。我们纳入了年龄≥18岁的患者,他们接受了至少1年的手术或RT随访。我们比较了3个月时的医疗保健利用率,使用治疗体重逆概率(IPTW)技术进行6个月和1年随访。
结果:确定了333名患者的队列。其中,72.7%(n=242)接受了RT,27.3%(n=91)接受了手术。RT的使用从2002-2004年(50%)增加到2017-2019年(91%)。手术队列中的患者年龄较小(中位年龄49岁vs.56年,p<0.0001),并且具有较高的3+合并症指数(34%与30%,p=0.43)与RT队列中的患者相比。接受手术的患者在住院时并发症较高(22%vs.6%,p<0.0001)和30天(14%vs.5%,p=0.0042)。合并指数和6或12个月付款没有差异(6个月:手术,$66108,RT:$43509,p=0.1034;12个月:手术,73259美元,RT:51576美元,p=0.1817)。最初接受RT的患者中只有4%接受了RT,并且在12个月时没有接受手术。而最初接受手术的患者中有6%在12个月时接受了RT,2%在12个月时接受了手术.
结论:RT在GJT患者的治疗中起着越来越重要的作用,并发症较少,1年时医疗保健利用率相当。
The trend of practice pattern and impact on health care utilization for surgery and radiation therapy (RT) in patients with glomus jugulare tumors (GJTs) is not well defined.
The IBM (Armonk, NY) MarketScan database was queried using the ICD-9/10 and CPT 4th edition, 2000-2020. We included patients ≥18 years of age who underwent either surgery or RT with at-least 1-year follow-up. We compared the health care utilization at 3-month, 6-month, and 1-year follow up using the inverse probability of treatment weight technique.
A cohort of 333 patients was identified. Of these, 72.7% (n = 242) underwent RT and 27.3% (n = 91) underwent surgery. RT use increased from 2002-2004 (50%) to 2017-2019 (91%). Patients in the surgery cohort were younger (median age 49 vs. 56 years, P < 0.0001) and had a higher 3+ comorbidity index (34% vs. 30%, P = 0.43) compared with patients in the RT cohort. Patients who underwent surgery had higher complications at index hospitalization (22% vs. 6%, P < 0.0001) and at 30 days (14% vs. 5%, P = 0.0042). No difference in combined index and 6- or 12-month payments were noted (6-months: surgery, $66m108, RT: $43m509, P = 0.1034; 12-months: surgery, $73,259, RT: $51,576, P = 0.1817). Only 4% of patients who had initial RT underwent RT and none underwent surgery at 12 months, whereas 6% of patients who had initial surgery underwent RT and 2% underwent surgery at 12 months.
RT plays an increasingly important role in the treatment for patients with GJTs, with fewer complications and a comparable health care utilization at 1 year.