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Master Thesis

Étude rétrospective des implantations des neuromodulateurs des racines sacrées dans un centre hospitalier français : analyse de la durée de vie et des coûts hospitaliers

Abstract : Sacral root neuromodulation is a safe and effective therapy for the management of urinary, digestive and double incontinence. The generators InterStim™ and InterStim™ II (Medtronic™) are non-rechargeable active implantable medical devices with a limited lifespan. This retrospective study allowed us to assess the generators' mediane lifespan for all indications. From the electronical medical records and our traceability software, we extracted the implantation data of all stimulators implanted between 2007 and 2014. The second objective of the study was to model long-term hospital costs, from the point of view of health insurance, based on the reimbursement of the GHS. Our cohort included 215 patients and 242 pacemakers. The median observed lifetime of stimulators implanted in our center was 7.29 years and 5.9 years for InterStim™ and InterStim™II respectively using the Kaplan-Meier method. The difference in lifetime observed between the two generations was statistically significant. These results are consistent with manufacturer's lifetime estimations, data from the literature and the technical specifications of InterStim™ II. Furthermore, the modelling of primary implantation and renewal costs allowed us to observe that the decrease in the lifetime of Interstim™ II is associated with an increase in hospital costs over time. Our results give us the means to complete the information provided to our patients. The next step will be to compare the costs of sacral root neuromodulation according to the type of stimulator implanted, rechargeable or non-rechargeable. In this way, we hope to help the surgeon to choose the most appropriate stimulator for patients, while taking into consideration the economic aspect.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02963772
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Submitted on : Sunday, October 11, 2020 - 4:41:20 PM
Last modification on : Tuesday, November 24, 2020 - 4:00:18 PM

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Assia Daikh. Étude rétrospective des implantations des neuromodulateurs des racines sacrées dans un centre hospitalier français : analyse de la durée de vie et des coûts hospitaliers. Sciences pharmaceutiques. 2020. ⟨dumas-02963772⟩

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