Intraoperative MRI use in transsphenoidal surgery for pituitary tumors: Trends and healthcare utilization. (May 2023)

• Record Type: Journal Article
• Authors: Sharma, Mayur; Wang, Dengzhi; Scott, Victoria; Ugiliweneza, Beatrice; Potts, Kevin; Savage, Jesse; Boakye, Maxwell; Andaluz, Norberto; Williams, Brian J.
• Is Part Of: Journal of clinical neuroscience. Volume 111(2023)
• Page Start: 86
• Page End: 90
• Publication Date: 2023-05
• Subjects: Intraoperative MRI -- Pituitary tumor -- Healthcare utilization -- Surgery -- National database; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2023.03.009
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: To report the trends and the impact of iMRI on healthcare utilization in patients who underwent TSA for PTs using MarketScan database. Only 1.4% of patients had iMRI used during surgery for PTs. Use of iMRI remained stable from 2004–2019 ∼1.4%. Combined index payments were not significantly different without and with iMRI use at 6- and 12-months. Surgeons can choose iMRI depending on the availability and clinical need without healthcare burden. Abstract: Background: Intraoperative magnetic resonance imaging (iMRI) use in transsphenoidal approach (TSA) for pituitary tumors (PTs) has been reported to improve the extent of resection (EOR). The aim of this study is to report the trends and the impact of iMRI on healthcare utilization in patients who underwent TSA for PTs. Materials and methods: MarketScan database were queried using the ICD-9/10 and CPT-4, from 2004 to 2020. We included patients ≥ 18 years of age PTs with > 1 year follow-up. Outcomes were length of stay (LOS), discharge disposition, hospital/emergency room (ER) re-admissions, outpatient services, medication refills and corresponding payments. Results: A cohort of 10, 192 patients were identified from the database, of these 141 patients (1.4%) had iMRI used during the procedure. Use of iMRI for PTs remained stable (2004–2007: 0.85%; 2008–2011: 1.6%; 2012–2015:1.4% and 2016–2019: 1.46%). No differences in LOS (median 3 days each), discharge to home (93% vs. 94%), complication rates (7% vs. 13%) and payments ($34604 vs. $33050) at index hospitalization were noted. Post-discharge payments were not significantly different without and with iMRI use at 6-months ($8315 vs. $ 7577, p = 0.7) and 1-year ($13, 654 vs. $ 14, 054, p = 0.70), following the index procedure. Conclusion: iMRI use during TSA for PTs remained stable with no impact on LOS, complications, discharge disposition and index payments. Also, there was no difference in combined index payments at 6-months, and 1-year after the index procedure in patients with and without iMRI use for PTs.