OBJECTIVES

: Cerebral venous thrombosis (CVT) is a rare cause of stroke that affects ~1/100,000/year. About 10% of patients experience a fulminant fatal course or are left with marked residual disability. Long term sequellae can include issues with cognition, seizures and focal neurological deficits. We developed a methodology and costing algorithm that could be applied to future randomized controlled trials involving novel treatments for CVT.

METHODS

: A micro-costing analysis was carried out using ten years of administrative data (2008-2018) from a Vancouver General Hospital, the quaternary care stroke centre from British Columbia. Each stage of the inpatient journey was mapped alongside additional resource utilization including imaging and other diagnostics. Stages, including emergency department visits and transitions from levels of higher care, were valued using a combination of gross and activity-based costing. Overhead costs including administration and equipment were assigned based on square footage while personnel costs were allocated based on bed day.

RESULTS

: One hundred and thirty six patient admissions were identified through ICD-9 and 10 codes as having CVT as a primary or secondary diagnosis. Preliminary analysis has revealed a heterogeneity of CVT inpatient journeys with stays in critical care generating the most significant cost burden. Differences in journeys appear to be driven in part by whether CVT was a primary vs. secondary diagnosis (ie. complication of another disease process). Our analysis is ongoing and we will present a detailed analysis of each resource valuation as well as the costs of care for CVT patients.

CONCLUSIONS

: Costing of care for CVT can vary significantly. The differences between patients with primary and secondary diagnoses of CVT should be noted, particularly for future trials examining the cost-effectiveness of interventions that may only target patients with primary diagnoses. Future research should also examine the outpatient costs associated with recovery.