Page 107 - DECISION-MAKING IN SEVERE TRAUMATIC BRAIN INJURY PATIENT OUTCOME, HOSPITAL COSTS, AND RESEARCH PRACTICE

Outcome versus in-hospital costs: a neurosurgical paradox?
a long-term follow up and should use accurate resource utilization and cost price information. 48,49 Future research should also explore the societal impact of t-ASDH, including productivity loss of both patients and proxies. Investigators should aim at comparability and generalizability by using common data points and guideline recommendations. 50 Ultimately, researchers should explore what health states and associated costs can be considered ‘acceptable’ to patients, proxies and society.
CONCLUSIONS 4
Although outcome was often “unfavourable”, several of the most severely injured patients, often even considered unsalvageable, achieved favourable outcome on both GOS and QOLIBRI. Associated hospital costs were relatively high, especially for the most severely injured patients, but may be justified considering the realized favourable outcome in part of these patients. Patients should not prematurely be considered unsalvageable and adequate (surgical) therapy should not be withheld in the acute phase. More research is necessary to establish the cost-effectiveness of treatment strategies for patients with a t-ASDH.
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