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Cost-effectiveness analysis of the diagnosis of temporal arteritis.
Del Blanco Alonso, Isabel; Revilla Calavia, Álvaro; Saiz-Viloria, Laura; Diez Martínez, Manuel; San Norberto García, Enrique; Vaquero Puerta, Carlos.
Afiliación
  • Del Blanco Alonso I; Servicio de Angiología y Cirugía Vascular, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. Electronic address: iblancoa@saludcastillayleon.es.
  • Revilla Calavia Á; Servicio de Angiología y Cirugía Vascular, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Saiz-Viloria L; Servicio de Angiología y Cirugía Vascular, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Diez Martínez M; Servicio de Angiología y Cirugía Vascular, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • San Norberto García E; Servicio de Angiología y Cirugía Vascular, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Vaquero Puerta C; Servicio de Angiología y Cirugía Vascular, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
Reumatol Clin (Engl Ed) ; 20(4): 181-186, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38614886
ABSTRACT
Temporal arteritis (TA) is the most common form of systemic vasculitis. Its diagnosis is based on criteria proposed by the American College of Rheumatology (1990), and its treatment is high-dose corticosteroids. Our objective is to assess the cost of diagnosing TA, and secondarily, cost-effective analysis of different diagnostic strategies (clinical, biopsy, doppler ultrasound) and therapeutic strategies (corticosteroid suspension). MATERIAL AND

METHOD:

Observational, retrospective study has been carried out on patients with AT (2012-2021). Demographic data, comorbidities, signs and symptoms suggestive of AT were collected. AT was diagnosed with a score ≥ 3 according to American College of Rheumatoloy criteria (ACR-SCORE). The costs of diagnosis and treatment modification were analysed.

RESULTS:

Seventy-five patients have been included, median age 77 (46-87) years. Headache, temporal pain and jaw claudication were significant for the diagnosis of TA. Patients with a halo on Doppler ultrasound and a positive biopsy have significantly elevated ESR and CRP compared to patients who do not. The cost of the AT diagnosis was 414.7 euros/patient. If we use ACR-SCORE ≥ 3-echodoppler it is 167.2 є/patient (savings 59.6%) and ACR-SCORE ≥ 3-biopsy 339.75 є/patient (savings 18%). If the corticosteroid was removed and a biopsy was performed, 21.6 є/patient (94.7% savings), if the corticosteroid was removed and Doppler ultrasound was performed, 10.6 є/patient (97.4% savings).

CONCLUSIONS:

Headache, temporary pain and jaw claudication are predictors of AT. Elevated ESR and CRP are predictors of positive biopsy and presence of halo on ultrasound. The uses of ACR-SCORE ≥ 3 with Doppler ultrasound or biopsy, and with corticosteroid suspension, are cost-effective.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Arteritis de Células Gigantes / Análisis Costo-Beneficio Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Reumatol Clin (Engl Ed) Año: 2024 Tipo del documento: Article Pais de publicación: España
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Arteritis de Células Gigantes / Análisis Costo-Beneficio Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Reumatol Clin (Engl Ed) Año: 2024 Tipo del documento: Article Pais de publicación: España