A 10-Year Retrospective Study of 490 Hip Fracture Patients: Reoperations, Direct Medical Costs, and Survival
| Autor: | Juha-Pekka Kaukonen, Teemu Helkamaa, P. Lüthje, R. Alaranta, Ilona Nurmi-Lüthje, R. Tiihonen |
|---|---|
| Přispěvatelé: | HYKS erva, Päijät-Häme Welfare Consortium, I kirurgian klinikka (Töölö), Clinicum, University of Helsinki, HUS Musculoskeletal and Plastic Surgery, Department of Public Health |
| Rok vydání: | 2018 |
| Předmět: |
Male
Reoperation medicine.medical_specialty medicine.medical_treatment costs complication DISPLACED FRACTURES SURGICAL APPROACH survival Hip fracture 03 medical and health sciences Fracture Fixation Internal INTERNAL-FIXATION 0302 clinical medicine medicine Internal fixation Humans Arthroplasty Replacement Acute hospital Femoral neck Aged Retrospective Studies Aged 80 and over Surgical approach business.industry Hip Fractures MORTALITY Retrospective cohort study Health Care Costs SERVICES 3126 Surgery anesthesiology intensive care radiology medicine.disease 3. Good health Surgery Survival Rate medicine.anatomical_structure Treatment Outcome HEMIARTHROPLASTIES 030220 oncology & carcinogenesis DISLOCATION 030211 gastroenterology & hepatology Female FEMORAL-NECK Complication business Medical costs |
| Zdroj: | Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society. 108(2) |
| ISSN: | 1799-7267 |
| Popis: | Background and Aims: Reoperations after operative treatment of hip fracture patients may be associated with higher costs and inferior survival. We examined the acute hospital costs, long-term reoperation rates, and survival of patients with a new hip fracture. Materials and Methods: A total of 490 consecutive new hip fracture patients treated at a single center between 31 December 2004 and 6 December 2006 were analyzed retrospectively. Fractures were classified according to Garden and AO. All medical records were checked manually. The costs of reoperations were calculated using the diagnosis-related groups (DRG)-based prices. Survival analysis was performed using the life-table method. The follow-up time was 10 years. Results: In all, 70/490 patients (14.3%) needed reoperations. Of all reoperations, 34.2% were performed during the first month and 72.9% within 1 year after the primary operation. The hemiarthroplasty dislocation rate was 8.5%, and mechanical failures of osteosynthesis occurred in 6.2%. Alcohol abuse was associated with a heightened risk of reoperation. The mean direct costs of primary fracture care were lower than the mean costs of reoperations (€7500 vs €9800). The mortality rate at 10 years was 79.8% among non-reoperated patients and 62.9% among reoperated patients. Conclusions: According to our hypothesis, the cost per patient of reoperation in acute care was 31% higher than the corresponding cost of a primary operation. Reoperations increased the overall immediate costs of index fractures by nearly 20%. One-third of all reoperations were performed during the first month and almost 75% within 1 year after the primary operation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|