The effect of music interventions compared to standard-of-care on the prevention of delirium in neurosurgical patients: an analysis of costs and cost-effectiveness based on the MUSYC-trial

IF 1.9 3区医学 Q3 CLINICAL NEUROLOGY Acta Neurochirurgica Pub Date : 2025-02-14 DOI:10.1007/s00701-025-06448-0

Thomas L.A. Dirven, Pablo R. Kappen, Frederike Ten Harmsen van der Beek, Bronno van der Holt, Hans Jeekel, Clemens M.F. Dirven, Arnaud J.P.E. Vincent, Markus Klimek, Marten J. Poley

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Abstract

Background

Postoperative delirium is a frequent complication with negative consequences for neurosurgical patients. Recorded music has been shown to reduce the incidence of delirium, however its economic benefit remains unclear. This study aimed to investigate the cost-effectiveness of perioperative music in preventing postoperative delirium.

Methods

This study used data from a randomized controlled trial (Clinical Trials.gov; NCT04649450) that compared the effect of perioperative music with standard of clinical care on the occurrence of postoperative delirium in patients undergoing craniotomy at the Erasmus Medical Centre. The primary outcome of this study is the cost-effectiveness of the music intervention. A trial-based cost-effectiveness analysis (CEA) was conducted from a societal perspective. Mean costs were calculated using bootstrapping with 95% confidence intervals. Secondary outcomes included postoperative complications, mortality, cognitive functioning, and quality of life. Costs and patient outcomes were assessed separately for the initial hospital admission and long-term follow-up until 6 months after discharge.

Results

This study included 91 patients in the intervention group and 93 in the control group. On average, medical costs during initial admission were lower, albeit not statistically significant, in the music group compared to the control group (€ 11,819 vs. € 13,106), mostly due to a shorter length of stay. Total costs over the 6-month period were nearly identical between the groups, at € 18,587 and € 18,571 in the music and control group, respectively.

Conclusions

Pre-recorded perioperative music may be a cost-effective intervention for reducing postoperative delirium in neurosurgical patients, possibly by decreasing healthcare utilization and costs during primary admission. Further studies are needed to confirm its potential as a cost-effective intervention.

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音乐干预与标准治疗对神经外科患者谵妄预防的影响：基于musyc试验的成本和成本效益分析

背景：术后谵妄是神经外科患者常见的不良并发症。录制音乐已被证明可以减少谵妄的发生率，但其经济效益尚不清楚。本研究旨在探讨围手术期音乐预防术后谵妄的成本-效果。方法本研究使用的数据来自一项随机对照试验(Clinical Trials.gov；NCT04649450)，比较了围手术期音乐与标准临床护理对伊拉斯谟医学中心开颅手术患者术后谵妄发生的影响。本研究的主要结果是音乐干预的成本效益。从社会角度进行了基于试验的成本效益分析（CEA）。平均成本采用自举法计算，置信区间为95%。次要结局包括术后并发症、死亡率、认知功能和生活质量。对首次住院和出院后6个月的长期随访分别评估费用和患者结局。结果干预组91例，对照组93例。平均而言，与对照组相比，音乐组首次入院时的医疗费用较低（11,819欧元对13,106欧元），尽管没有统计学意义，主要原因是住院时间较短。6个月期间，两组之间的总花费几乎相同，音乐组和对照组分别为18587欧元和18571欧元。结论预录围手术期音乐可能是减少神经外科患者术后谵妄的一种经济有效的干预措施，可能通过降低初次入院时的医疗保健利用率和费用。需要进一步的研究来证实它作为一种具有成本效益的干预措施的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Neurochirurgica 医学-临床神经学

CiteScore

4.40

自引率

4.20%

发文量

342

审稿时长

1 months

期刊介绍： The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.