[Influence of complications and comorbidities on length of hospital stay and costs for surgical treatment of proximal humeral fractures].

Autor: Stolberg-Stolberg J; Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude W1, 48149, Münster, Deutschland. Josef.Stolberg-Stolberg@ukmuenster.de., Köppe J; Institut für Biometrie und Klinische Forschung, Westfälische Wilhelms-Universität Münster, Schmeddingstraße 56, 48149, Münster, Deutschland., Rischen R; Klinik für Radiologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland., Freistühler M; Geschäftsbereich Medizinisches Management-Medizincontrolling, Universitätsklinikum Münster, Niels-Stensen-Straße 8, 48149, Münster, Deutschland., Faldum A; Institut für Biometrie und Klinische Forschung, Westfälische Wilhelms-Universität Münster, Schmeddingstraße 56, 48149, Münster, Deutschland., Katthagen JC; Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude W1, 48149, Münster, Deutschland., Raschke MJ; Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude W1, 48149, Münster, Deutschland.
Jazyk: němčina
Zdroj: Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen [Chirurg] 2021 Oct; Vol. 92 (10), pp. 907-915. Date of Electronic Publication: 2021 Sep 17.
DOI: 10.1007/s00104-021-01491-w
Abstrakt: After a proximal humeral fracture in older patients, locked plate fixation and reverse total shoulder arthroplasty are two competing surgical procedures. Even if recent clinical studies indicate a functional superiority of reverse shoulder arthroplasty over locked plate fixation, health-economic comparative data are lacking in the literature. Health claims data of 55,070 patients aged 65 years or older who were treated with reverse total shoulder arthroplasty or locked plate fixation after proximal humeral fractures, were analyzed regarding length of hospital stay and costs. Multivariable linear regression models were used to analyze the influence of comorbidities and complications on the length of hospital stay and costs. The length of hospital stay after reverse total shoulder arthroplasty with 20.0 days (±13.5 days) was statistically noticeable longer compared to locked plate fixation with 14.6 days (±11.4 days, p < 0.001). The costs per case showed a clear difference with 11,165.70€ (±5884.36€) for reverse total shoulder arthroplasty and 7030.11€ (±5532.02€) for locked plate fixation (p < 0.001). Statistically noticeable cost increases due to comorbidities and complications underline the urgent need for specialized geriatric trauma centers.
(© 2021. The Author(s).)
Databáze: MEDLINE
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