잠시만 기다려 주세요. 로딩중입니다.

National Trends in the Treatment of Ruptured Cerebral Aneurysms in Korea Using an Age-adjusted Method

Journal of Korean Medical Science 2020년 35권 39호 p.323 ~ 323
박혜란, 김재헌, 박수연, 장재칠, 박석규,
소속 상세정보
박혜란 ( Park Hye-Ran ) - Soonchunhyang University College of Medicin Soonchunhyang University Seoul Hospital Department of Neurosurgery
김재헌 ( Kim Jae-Heon ) - Soonchunhyang University College of Medicine Soonchunhyang University Seoul Hospital Department of Urology
박수연 ( Park Su-Yeon ) - Soonchunhyang University College of Medicine Soonchunhyang University Seoul Hospital Department of Biostatistics
장재칠 ( Chang Jae-Chil ) - Soonchunhyang University College of Medicin Soonchunhyang University Seoul Hospital Department of Neurosurgery
박석규 ( Park Sukh-Que ) - Soonchunhyang University College of Medicin Soonchunhyang University Seoul Hospital Department of Neurosurgery

Abstract


Background: Two primary treatment methods are used for ruptured cerebral aneurysms, surgical clipping and endovascular coiling. In recent decades, endovascular coiling has shown remarkable progress compared to surgical clipping, along with technological developments. The aim of this study was to investigate the recent trends in treatments for ruptured cerebral aneurysms in Korea.

Methods: The data were obtained from the National Health Insurance database. We evaluated the trends in endovascular coiling and surgical clipping for ruptured aneurysms for the period 2000?2017. We obtained the number of prescriptions with International Classification of Diseases, 9th Revision, clinical modification codes related to nontraumatic subarachnoid hemorrhage and prescription codes S4641/4642 for surgical clipping and M1661/1662 for endovascular coiling. The medical expenses for each prescription were also obtained. The primary outcomes included the cumulative number of patients, patient rates per 100,000 people, and the correlation between patient rates and the percentage of the population in each age group.

Results: In the case of surgical clipping, there were no increasing or decreasing trends in the cumulative number of patients when the population/age group was ignored. When examining the trends in patient rates per 100,000 population at each year in male, there was no increasing or decreasing trend in the number of surgical clippings between the age groups, in spite of a decreasing tendency in the number of surgical clipping in male in their 40s and older than 60. In females, the surgical clipping rates tended to decrease only in patients older than 60 years, but there was no tendency to increase or decrease in the other ages. In contrast, the cumulative number of patients who underwent endovascular coiling for ruptured cerebral aneurysms increased year by year regardless of the population/age group. In both male and female, there was no increasing or decreasing trend only in the group aged 40 or younger and there was an increasing tendency in the rest of the age groups. In the trend of medical expenses, both the cost of surgical clipping and endovascular coiling showed increases. Specifically, the medical expense trend in endovascular coiling increased more rapidly than that for surgical clipping.

Conclusion: There was a significant increase in the proportion of patients with ruptured aneurysms undergoing endovascular coiling between 2010 and 2017, whereas the use of surgical clipping decreased. The endovascular coiling was significantly increased in all age groups and surgical clipping was decreased in all age groups, especially in patients under 50 years of age.

키워드

Cerebral Aneurysm; Subarachnoid Hemorrhage; Endovascular Technique; Microsurgical Clipping

원문 및 링크아웃 정보

 

등재저널 정보