A 10-Year Retrospective Study of 490 Hip Fracture Patients: Reoperations, Direct Medical Costs, and Survival

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Tiihonen , R , Alaranta , R , Helkamaa , T , Nurmi-Lüthje , I , Kaukonen , J-P & Lüthje , P 2019 , ' A 10-Year Retrospective Study of 490 Hip Fracture Patients: Reoperations, Direct Medical Costs, and Survival ' , Scandinavian Journal of Surgery , vol. 108 , no. 2 , pp. 178-184 . https://doi.org/10.1177/1457496918798197

Title: A 10-Year Retrospective Study of 490 Hip Fracture Patients: Reoperations, Direct Medical Costs, and Survival
Author: Tiihonen, R.; Alaranta, R.; Helkamaa, T.; Nurmi-Lüthje, I.; Kaukonen, J.-P.; Lüthje, P.
Contributor: University of Helsinki, HYKS erva
University of Helsinki, HYKS erva
University of Helsinki, I kirurgian klinikka (Töölö)
University of Helsinki, Department of Public Health
University of Helsinki, HYKS erva
Date: 2019-06
Language: eng
Number of pages: 7
Belongs to series: Scandinavian Journal of Surgery
ISSN: 1457-4969
URI: http://hdl.handle.net/10138/318036
Abstract: 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 (euro7500 vs euro9800). 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.
Subject: DISLOCATION
DISPLACED FRACTURES
FEMORAL-NECK
HEMIARTHROPLASTIES
Hip fracture
INTERNAL-FIXATION
MORTALITY
SERVICES
SURGERY
SURGICAL APPROACH
complication
costs
reoperation
survival
3126 Surgery, anesthesiology, intensive care, radiology
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