193 The Impact of Intracranial Pressure Telesensors on Service Demand & Costs in Adult Hydrocephalus

INTRODUCTION: Shunt systems are central in managing adult hydrocephalus by regulating CSF and intracranial pressure (ICP). Traditional methods for adjusting shunt drainage relied on symptomatic assessments and radiological interventions, leading to high resource utilisation and radiation exposure. The advent of implantable telemetric ICP sensors (telesensors), offers non-invasive and rapid ICP monitoring, supporting clinical decision-making and potentially reducing resource utilization. METHODS: This retrospective, propensity-matched, control study included adults treated for hydrocephalus with CSF diversion incorporating an MScio/Sensor Reservoir. Controls had a non-telemetric Sprung reservoir and were matched on demographics, diagnosis, shunt-type, and revision status. Data collected included neurosurgical admissions, outpatient clinics, imaging, and further surgeries, comparing 2 years before and after shunt implantation. Cost-effectiveness analyses were conducted using local tariffs, incorporating multivariate regression and propensity score matching. RESULTS: 136 patients (73 telesensor, 63 controls) were analysed in this study. Telesensor used led to significant reduction in neurosurgical inpatient admissions and procedures, including ICP monitoring. Telesensor patients also had, on average, 3.9 fewer x-rays and 1.4 fewer CT scans than controls, translating to an average radiation dose reduction of 4.00 mSv over two years (p = 0.009). Propensity-matched analysis included 48 pairs of patients, demonstrating significant cost savings, particularly in the first-year post-implantation of $5597 (p = 0.03), and cumulatively over the two-year follow-up of $6338 (p = 0.04). This was primarily driven by reduced costs associated with neurosurgical inpatient admissions and imaging. Break-even analysis shows cost-savings were likely to be achieved within 8 months of clinical use, post-implantation. CONCLUSIONS: Telesensor implantation significantly reduced patient radiation exposure and service utilisation, as well as providing institutional net financial savings. These findings support the adoption of telesensor technology as a cost-effective option for enhancing patient care.