Introduction
Methods
Study design and setting
Patient population
Variables
Outcomes
Statistical analyses
Results
Patient baseline characteristics
Criteria | All patients (N = 246) | Non-FRI (N = 201) | Single FRI (N = 30) | FRI recurrence (N = 15) |
---|---|---|---|---|
Patient characteristics | ||||
Gender (male), N (%) | 146 (59) | 117 (58) | 19 (63) | 10 (67) |
Age (years), median (IQR) | 42 (27–57) | 38 (25–55) | 57 (42–66) | 50 (28–60) |
BMI (kg/m2), mean (SD) (N = 230) | 25 (4) | 25 (4) | 25 (5) | 24 (3) |
Smoking, N (%) (N = 203) | 78 (32) | 67 (33) | 5 (17) | 6 (40) |
ASA, N (%) ASA 1 ASA 2 ASA 3 ASA 4 | 143 (58) 97 (39) 6 (2) 0 | 119 (59) 77 (38) 5 (3) 0 | 16 (53) 13 (43) 1 (3) 0 | 8 (53) 7 (65) 0 0 |
CCI (%10-year survival), median (IQR) | 98 (96–98) | 98 (96–98) | 96 (90–98) | 96 (90–98) |
Trauma characteristics | ||||
Trauma mechanism, N (%) Car Motorbike/scooter Cyclist Pedestrian Fall Other | 25 (10) 45 (18) 50 (20) 9 (4) 83 (34) 34 (14) | 22 (11) 35 (18) 38 (19) 4 (2) 73 (36) 29 (14) | 2 (7) 5 (13) 8 (27) 4 (13) 8 (27) 3 (10) | 1 (7) 5 (33) 4 (27) 1 (7) 2 (13) 2 (13) |
High-energy trauma, N (%) | 97 (39) | 78 (39) | 12 (40) | 7 (47) |
Crush injury, N (%) | 17 (7) | 12 (6) | 2 (7) | 3 (20) |
ISS, median (IQR) | 9 (4–9) | 6 (4–9) | 9 (4–10) | 9 (4–11) |
Fracture characteristics | ||||
AO/OTA location, N (%) Humerus Forearm Femur Tibia/fibula | 20 (8) 64 (26) 47 (19) 115 (47) | 19 (10) 56 (28) 43 (21) 83 (41) | 1 (3) 6 (20) 3 (10) 20 (67) | 0 2 (13) 1 (7) 12 (80) |
AO/OTA fracture type, N (%) A 1 / 2 / 3 B 1 / 2 / 3 C 1 / 2 / 3 | 8 (3) / 25 (10) / 22 (9) 19 (8) / 18 (7) / 40 (16) 10 (4) / 26 (11) / 78 (32) | 7 (4) / 21 (10) / 19 (10) 14 (7) / 13 (7) / 37 (18) 5 (3) / 18 (9) / 67 (33) | 0 / 3 (10) / 2 (7) 4 (13) / 3 (10) / 2 (7) 4 (13) / 5 (17) / 7 (23) | 1 (7) / 1 (7) / 1 (7) 1 (7) / 2 (13) / 1 (7) 1 (7) / 3 (20) / 4 (27) |
Soft tissue status (open), N (%) | 60 (24) | 35 (17) | 15 (50) | 10 (67) |
Gustilo grade open fractures, N (%) 1 2 3 A / B / C | 18 (7) 20 (8) 9 (4) / 10 (4) / 3 (1) | 12 (6) 13 (7) 6 (3) / 3 (2) / 1 (1) | 10 (33) 5 (17) 3 (10) / 2 (7) / 1 (3) | 2 (13) 2 (13) 0 / 5 (33) / 1 (7) |
Primary outcome: direct healthcare costs
Outcome | Non-FRI (N = 201) | Single FRI (N = 30) | FRI recurrence (N = 15) |
---|---|---|---|
Direct healthcare costs in ratios | |||
Total costs, ratio | 1.0 | 3.1 | 7.6 |
Hospitalisation costs, ratio | 1.0 | 5.0 | 12.6 |
Surgery costs, ratio | 1.0 | 2.3 | 4.2 |
Consult costs, ratio | 1.0 | 1.8 | 5.1 |
Imaging costs, ratio | 1.0 | 2.1 | 3.1 |
Other costs, ratio | 1.0 | 4.8 | 12.5 |
Healthcare utilisation | |||
Direct closure possible, N (%) | 197 (98) | 27 (90) | 8 (53) |
Additional surgeries (N), median (IQR) | 0 (0–1) | 2 (1–4) | 7 (4–11) |
Implant removal, N (%) | 55 (27) | 14 (47) | 10 (67) |
Total LOS (days), median (IQR) | 5 (3–10) | 25 (16–33) | 50 (36–95) |
Additional admissions (N), median (IQR) | 0 (0–0) | 1 (1–2) | 3 (2–6) |
Antibiotics costs (euros), median (IQR) | NA | 765 (470 − 1.150) | 1.350 (170 − 3.130) |
Antibiotic duration (days), median (IQR) Total (IV + oral) IV only | NA NA | 35 (23–43) 21 (10–41) | 77 (22–114) 55 (35–126) |
Follow-up period (years), median (IQR) | 1.0 (0.5–1.6) | 1.3 (0.8–2.2) | 3.0 (1.8-4.0) |