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

Autors de IIS La Fe

• Ana Barres Fernandez

  Autor

• José Baeza Oliete

  Autor

• Antonio Balfagon Ferrer

  Autor

Autors aliens a IIS La Fe

• Navarrete-Dualde, Jorge
• Quintana Plaza J
• Escalona, Elena
• Muehlendyck, Christian
• Galvain, Thibaut

Grups d'Investigació

• Cirugía Ortopédica y Traumatología

  

  Leader

  Francisco Baixauli García

• Infección Grave

  

  Investigador Principal

  María Ángeles Tormo Mas

Abstract

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.

Copyright: © 2022 Barrés-Carsí et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Keywords

• SITE INFECTION; COATED NAILS; CONSEQUENCES; PREVENTION; COMPLICATIONS; FIXATION; RATES