Healthcare resource use and costs related to surgical infections of tibial fractures in a Spanish cohort
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...
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| Veröffentlicht in: | PloS one 2022-11, Vol.17 (11), p.e0277482-e0277482 |
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| creator | Barrés-Carsí, Mariano Navarrete-Dualde, Jorge Quintana Plaza, Javier Escalona, Elena Muehlendyck, Christian Galvain, Thibaut Baeza, José Balfagón, Antonio |
| description | 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 |
| doi_str_mv | 10.1371/journal.pone.0277482 |
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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 [euro]7,607 to [euro]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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0277482</identifier><identifier>PMID: 36367898</identifier><language>eng</language><publisher>San Francisco, CA USA: Public Library of Science</publisher><subject>Analysis ; Biology and Life Sciences ; Engineering and Technology ; Health care rationing ; Injuries ; Internal fixation in fractures ; Leg ; Medical care, Cost of ; Medicine and Health Sciences ; Methods ; Patient outcomes ; Physical Sciences ; Prevention ; Research and Analysis Methods ; Risk factors ; Social Sciences ; Surgical wound infections</subject><ispartof>PloS one, 2022-11, Vol.17 (11), p.e0277482-e0277482</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>2022 Barrés-Carsí et al 2022 Barrés-Carsí et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c481t-58a3b9ed269733435e2a0499017f815c9a0fffdbed905475fd8da74a2051eeb53</citedby><cites>FETCH-LOGICAL-c481t-58a3b9ed269733435e2a0499017f815c9a0fffdbed905475fd8da74a2051eeb53</cites><orcidid>0000-0002-4516-0441 ; 0000-0002-0412-249X ; 0000-0003-1335-2681</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9651570/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9651570/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2928,27924,27925,53791,53793</link.rule.ids></links><search><contributor>Farouk, Osama</contributor><creatorcontrib>Barrés-Carsí, Mariano</creatorcontrib><creatorcontrib>Navarrete-Dualde, Jorge</creatorcontrib><creatorcontrib>Quintana Plaza, Javier</creatorcontrib><creatorcontrib>Escalona, Elena</creatorcontrib><creatorcontrib>Muehlendyck, Christian</creatorcontrib><creatorcontrib>Galvain, Thibaut</creatorcontrib><creatorcontrib>Baeza, José</creatorcontrib><creatorcontrib>Balfagón, Antonio</creatorcontrib><title>Healthcare resource use and costs related to surgical infections of tibial fractures in a Spanish cohort</title><title>PloS one</title><description>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 [euro]7,607 to [euro]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.</description><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Engineering and Technology</subject><subject>Health care rationing</subject><subject>Injuries</subject><subject>Internal fixation in fractures</subject><subject>Leg</subject><subject>Medical care, Cost of</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Patient outcomes</subject><subject>Physical Sciences</subject><subject>Prevention</subject><subject>Research and Analysis Methods</subject><subject>Risk factors</subject><subject>Social Sciences</subject><subject>Surgical wound infections</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNqNkl9rFDEUxQdRbK1-Ax8CgujDrvkzmWRehFLUFgoFq76GO5mbnZTZyZpkin57s91FOuCD5CHh3N89hHtPVb1mdM2EYh_uwhwnGNe7MOGacqVqzZ9Up6wVfNVwKp4-ep9UL1K6o1QK3TTPqxPRiEbpVp9WwyXCmAcLEUnEVDwtkjkhgaknNqScijxCxp7kQNIcN97CSPzk0GYfpkSCI9l3vogugs1zcSllAuR2B5NPQ3EZQswvq2cOxoSvjvdZ9f3zp28Xl6vrmy9XF-fXK1trlldSg-ha7HnTKiFqIZEDrduWMuU0k7YF6pzrO-xbKmslXa97UDVwKhliJ8VZ9fHgu5u7LfYWpxxhNLvotxB_mwDeLCuTH8wm3Ju2kUwqWgzeHQ1i-Dljymbrk8VxhAnDnAxXQuqmroUu6JsDuoERTZlJKI52j5tzxRvOyw9Zodb_oMrpcett2Z7zRV80vF80FCbjr7yBOSVzdfv1_9mbH0v27SN2eFh8CuP8sMclWB9AG0NKEd3f8TFq9uEzx_CZffjMMXziD8sLzeU</recordid><startdate>20221111</startdate><enddate>20221111</enddate><creator>Barrés-Carsí, Mariano</creator><creator>Navarrete-Dualde, Jorge</creator><creator>Quintana Plaza, Javier</creator><creator>Escalona, Elena</creator><creator>Muehlendyck, Christian</creator><creator>Galvain, Thibaut</creator><creator>Baeza, José</creator><creator>Balfagón, Antonio</creator><general>Public Library of Science</general><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4516-0441</orcidid><orcidid>https://orcid.org/0000-0002-0412-249X</orcidid><orcidid>https://orcid.org/0000-0003-1335-2681</orcidid></search><sort><creationdate>20221111</creationdate><title>Healthcare resource use and costs related to surgical infections of tibial fractures in a Spanish cohort</title><author>Barrés-Carsí, Mariano ; Navarrete-Dualde, Jorge ; Quintana Plaza, Javier ; Escalona, Elena ; Muehlendyck, Christian ; Galvain, Thibaut ; Baeza, José ; Balfagón, Antonio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c481t-58a3b9ed269733435e2a0499017f815c9a0fffdbed905475fd8da74a2051eeb53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Engineering and Technology</topic><topic>Health care rationing</topic><topic>Injuries</topic><topic>Internal fixation in fractures</topic><topic>Leg</topic><topic>Medical care, Cost of</topic><topic>Medicine and Health Sciences</topic><topic>Methods</topic><topic>Patient outcomes</topic><topic>Physical Sciences</topic><topic>Prevention</topic><topic>Research and Analysis Methods</topic><topic>Risk factors</topic><topic>Social Sciences</topic><topic>Surgical wound infections</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barrés-Carsí, Mariano</creatorcontrib><creatorcontrib>Navarrete-Dualde, Jorge</creatorcontrib><creatorcontrib>Quintana Plaza, Javier</creatorcontrib><creatorcontrib>Escalona, Elena</creatorcontrib><creatorcontrib>Muehlendyck, Christian</creatorcontrib><creatorcontrib>Galvain, Thibaut</creatorcontrib><creatorcontrib>Baeza, José</creatorcontrib><creatorcontrib>Balfagón, Antonio</creatorcontrib><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barrés-Carsí, Mariano</au><au>Navarrete-Dualde, Jorge</au><au>Quintana Plaza, Javier</au><au>Escalona, Elena</au><au>Muehlendyck, Christian</au><au>Galvain, Thibaut</au><au>Baeza, José</au><au>Balfagón, Antonio</au><au>Farouk, Osama</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Healthcare resource use and costs related to surgical infections of tibial fractures in a Spanish cohort</atitle><jtitle>PloS one</jtitle><date>2022-11-11</date><risdate>2022</risdate><volume>17</volume><issue>11</issue><spage>e0277482</spage><epage>e0277482</epage><pages>e0277482-e0277482</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><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 [euro]7,607 to [euro]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.</abstract><cop>San Francisco, CA USA</cop><pub>Public Library of Science</pub><pmid>36367898</pmid><doi>10.1371/journal.pone.0277482</doi><tpages>e0277482</tpages><orcidid>https://orcid.org/0000-0002-4516-0441</orcidid><orcidid>https://orcid.org/0000-0002-0412-249X</orcidid><orcidid>https://orcid.org/0000-0003-1335-2681</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis Biology and Life Sciences Engineering and Technology Health care rationing Injuries Internal fixation in fractures Leg Medical care, Cost of Medicine and Health Sciences Methods Patient outcomes Physical Sciences Prevention Research and Analysis Methods Risk factors Social Sciences Surgical wound infections |
| title | Healthcare resource use and costs related to surgical infections of tibial fractures in a Spanish cohort |
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