应用真实世界数据分析评估丁苯酞治疗缺血性脑卒中的效果和经济学

Effectiveness and Economic Efficiency of Butylphthalide in the Treatment of Ischemic Stroke: a Real-World Data Analysis

目的探讨在真实世界中丁苯酞治疗缺血性脑卒中患者的效果和经济学。方法基于真实世界数据库建立缺血性脑卒中患者研究型数据库。根据患者首次诊断为缺血性脑卒中时是否使用丁苯酞将患者分为丁苯酞组和对照组,构建基线变量和结局变量,通过倾向性评分按1:1匹配丁苯酞组和对照组,比较两组缺血性脑卒中再住院率和医疗费用。结果倾向性评分匹配后丁苯酞组与对照组患者年龄、性别、脑卒中严重程度、共病情况比较,差异无统计学意义(P>0.05)。丁苯酞组30 d内有缺血性脑卒中诊断的再住院率和后续有缺血性脑卒中诊断的再住院率显著低于对照组(30 d内再住院率:1.8%比5.04%,P<0.05;后续再住院率:24.1%比40.65%,P<0.001)。同时,比较两组费用指标的绝对值,丁苯酞组所有指标低于对照组。脑卒中诊断当次及后续所有医疗费用:6 566 529.77元比9 265 515.10元;后续所有医疗费用:1 617 400.69元比4 582 948.83元;后续30 d内医疗费用:109 712.55元比368 305.99元;脑卒中相关医疗费用:5 937 674.66元比7 409 287.11元。结论真实世界数据研究显示丁苯酞治疗缺血性脑卒中具有良好的效果和经济学。

Objective To explore the effectiveness and economic efficiency of Butylphthalide in the treatment for ischemic stroke in the real-world setting. Methods A research database for patients with ischemic stroke was established based on a real-world database. Baseline and outcome variables were constructed by dividing patients into a Butylphthalide group and a control group based on whether or not the patient diagnosed with ischemic stroke for the first time used Butylphthalide or not. The Butylphthalide group and the control group were matched 1: 1 using propensity score matching, and the recurrence rates of ischemic stroke and medical costs between the 2 groups were compared. Results There was no statistically significant difference in age, gender, stroke severity, and comorbidity between the butylphthalide group and the control group after matching the propensity scores(P>0.05). The rehospitalization rate of ischemic stroke diagnosis within 30 days and the subsequent rehospitalization rate of subsequent ischemic stroke diagnosis in the butylphthalide group were significantly lower than that of the control group(rehospitalization rate within 30 days: 1.8% vs. 5.04%, P<0.05;follow-up rehospitalization rate: 24.1% vs. 40.65%, P<0.001). At the same time, the absolute value of the 2 groups of cost indicators were compared, all the indicators in the butylphthalide group were lower than the control group. All medical expenses for the current and subsequent stroke diagnosis: 6 566 529.77 vs. 9 265 515.10;all subsequent medical expenses: 1 617 400.69 vs. 4 582 948.83;medical expenses within the next 30 days: 109 712.55 vs. 368 305.99;stroke-related medical expenses : 5 937 674.66 to 7 409 287.11. Conclusion Real-world data study has shown that Butylphthalide has a good effectiveness and economics efficiency in the treatment of ischemic stroke.