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Healthcare resource use and costs related to surgical infections of tibial fractures in a Spanish cohort

Barrés-Carsí, M, Navarrete-Dualde, J, Plaza, JQ, Escalona, E, Muehlendyck, C, Galvain, T, Baeza, J and Balfagón, A (2022) Healthcare resource use and costs related to surgical infections of tibial fractures in a Spanish cohort. PLoS ONE, 17 (11).

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Surgical site infection constitutes a serious complication in the healing process of bone fractures and has been associated with increases in medical resource use and healthcare costs. This study evaluates the economic impact of surgical site infection in tibial fractures in a Spanish cohort. It is a retrospective, single-centre, comparative cohort study of patients with tibial fractures with longitudinal follow-up for up to 18 months post-surgery. Included patients (n = 325) were adults, with tibial fracture, either isolated or polyfracture, or polytrauma with an Injury Severity Score >15. Patients had been surgically treated within 30 days of the tibial fracture by external or internal fixation, or external followed by internal fixation. Most patients (84.9%) had an American Society of Anaesthesiology score of 1–2. 20% of the patients had one open tibial fracture, 12.3% had polytrauma, and 20% had multiple fractures. Most patients were treated with a nail (41.8%) or a plate (33.8%). 56 patients (17.2%) developed surgical site infection. Patients with infection had significantly higher hospital length of stay (34.9 vs 12.0 days; p<0.001; +191%), readmissions (1.21 vs 0.25; p<0.001; +380%) and mean operating theatre time (499 vs 219 min; p<0.001; +128%) than patients without infection. Mean length of stay in intensive care did not significantly increase with infection (2.8 vs 1.7 days; p = 0.25). Total in-hospital costs for patients with infection increased from €7,607 to €17,538 (p<0.001; +131%). Overall, infections were associated with significantly increased healthcare resource use and costs. Preventive strategies to avoid infections could lead to substantial cost savings.

Item Type: Article
Uncontrolled Keywords: Humans; Surgical Wound Infection; Tibial Fractures; Multiple Trauma; Treatment Outcome; Fracture Fixation, Internal; Retrospective Studies; Cohort Studies; Fracture Healing; Adult; Delivery of Health Care; Adult; Humans; Tibial Fractures; Surgical Wound Infection; Retrospective Studies; Cohort Studies; Treatment Outcome; Fracture Fixation, Internal; Multiple Trauma; Delivery of Health Care; Fracture Healing; General Science & Technology
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Nursing & Allied Health
Psychology (from Sep 2019)
Public Health Institute
Publisher: Public Library of Science (PLoS)
SWORD Depositor: A Symplectic
Date Deposited: 27 Jun 2024 16:01
Last Modified: 27 Jun 2024 16:15
DOI or ID number: 10.1371/journal.pone.0277482
Editors: Farouk, O
URI: https://researchonline.ljmu.ac.uk/id/eprint/23657
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