The clinical and economic burden of proximal femur periprosthetic fractures

被引：7

作者：

Aprato A. ^{[1
,2
]}

Tosto F. ^{[1
]}

Comba A. ^{[1
]}

Mellano D. ^{[1
]}

Piccato A. ^{[1
]}

Daghino W. ^{[1
]}

Massè A. ^{[1
]}

机构：

[1] Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Via Zuretti, Torino

[2] University of Turin, Viale 25 aprile 137 int 6 10133, Torino

来源：

MUSCULOSKELETAL SURGERY | 2022年 / 106卷 / 2期

关键词：

Clinical results; Costs; Femur fractures; Hip fractures; Life quality; Periprosthetic fractures;

D O I：

10.1007/s12306-020-00694-4

中图分类号：

学科分类号：

摘要：

Background: The number of hip replacements is constantly and progressively increasing, resulting in an increase in periprosthetic fractures. The main aim of this study is to analyze costs and outcomes of surgical treatment for those fractures. Materials and methods: A retrospective study was performed on periprosthetic proximal femur fracture presented a single-level I trauma center. Medical records were reviewed in terms of demographic data, diagnosis (according to Vancouver classification), type of surgical treatment, hospitalization length and follow-up. Patients were interviewed about number of consultations after discharge, medications and physiotherapy sessions. Clinical outcome was evaluated with WOMAC score at the last follow-up, and patient health status was evaluated with the EQ5D5L score pre-trauma and at the last follow-up. Patients were divided into two groups according to surgical treatment: reduction and internal fixation alone and revision plus fixation. A further group was also considered: patients underwent a Girdlestone procedure. Global costs for each group were calculated. Results: We initially recruited 117 patients, 17 of them were lost at follow-up. Furthermore, 19 patients (19%) died during the follow-up, and 81 of them were therefore included in the study. Mean follow-up was 26.5 months. Mean postoperative WOMAC score was 39.44, and EQ5D5L score was 9.12 for the preoperative period and 12.35 at the last follow-up. A significant worsening of clinical conditions was found comparing the period before fracture to the last follow-up (p < 0.01). Quality of life after surgery resulted to be poor or fair in 40% of the patients at a mean follow-up of 26.5 months. No significant differences between groups were found according to patients' health status. Mean global costs for mayor surgeries were 18,822 Euros; mean costs for fixation alone were 17,298 Euros while for fixation and revision were 20,966 Euros, but no statistically difference was found between these two groups. Mean cost for Girdlestone group was 12,664 Euros. Conclusions: In proximal femur periprosthetic fractures, either fixation or revision plus fixation presents high costs but patients’ postoperative quality of life is poor. © 2021, Istituto Ortopedico Rizzoli.

引用

页码：201 / 206

页数：5

共 28 条

[11]

Doyle D.J., Goyal A., Bansal P., Et al., American society of anesthesiologists classification (ASA Class) [Updated 2020 Jul 4]. In: Statpearls [Internet], Treasure Island (FL): Statpearls Publishing

[12]

Available From, (2020)

[13]

Ackerman I.N., Tacey M.A., Ademi Z., Bohensky M.A., Liew D., Brand C.A., Using WOMAC index scores and personal characteristics to estimate assessment of quality of life utility scores in people with hip and knee joint disease, Qual Life Res, 23, pp. 2365-2374, (2014)

[14]

Walker L.C., Clement N.D., Bardgett M., Weir D., Holland J., Gerrand C., Deehan D.J., The WOMAC score can be reliably used to classify patient satisfaction after total knee arthroplasty, Knee Surg Sport Traumatol Arthrosc, 26, pp. 3333-3341, (2018)

[15]

Adam T., Evans D.B., Murray C.J., Econometric estimation of country-specific hospital costs, Cost Eff Resour Alloc, 26, 1, (2003)

[16]

Tan S.S., Bakker J., Hoogendoom M.E., Et al., Direct cost analysis of intensive care unit stay in four European countries: applying a standardized costing methodology, Val Health, 15, pp. 81-86, (2012)

[17]

Macario A., What does one minute of operating room time cost?, J Clin Anesth, 22, pp. 233-236, (2010)

[18]

Piscitelli P., Iolascon G., Et al., Incidence and costs of hip fractures vs strokes and acute myocardial infarction in Italy: comparative analysis based on national hospitalization records, Clin Interv Aging, 7, pp. 575-583, (2012)

[19]

Ruscitti G., Tutti I Costi Delle Trasfusioni, pp. 1-7, (2008)

[20]

Lernout T., Labalette C., Sedel L., Kormann P., Duteil C., Le Divenah A., Bertrand D., Cost analysis in total hip arthroplasty: experience of a teaching medical center located in paris, Orthop Traumatol Surg Res, 96, 2, pp. 113-123, (2010)

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