单纯性肘关节脱位的成本分析与结果
Cost analysis and outcomes of simple elbow dislocations.
作者信息
Panteli Michalis, Pountos Ippokratis, Kanakaris Nikolaos K, Tosounidis Theodoros H, Giannoudis Peter V
机构信息
Michalis Panteli, Ippokratis Pountos, Peter V Giannoudis, Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Clarendon Wing, Level A, Leeds LS1 3EX, United Kingdom.
出版信息
World J Orthop. 2015 Aug 18;6(7):513-20. doi: 10.5312/wjo.v6.i7.513.
AIM
To evaluate the management, clinical outcome and cost implications of three different treatment regimes for simple elbow dislocations.
METHODS
Following institutional board approval, we performed a retrospective review of all consecutive patients treated for simple elbow dislocations in a Level I trauma centre between January 2008 and December 2010. Based on the length of elbow immobilisation (LOI), patients were divided in three groups (Group I, < 2 wk; Group II, 2-3 wk; and Group III, > 3 wk). Outcome was considered satisfactory when a patient could achieve a pain-free range of motion ≥ 100° (from 30° to 130°). The associated direct medical costs for the treatment of each patient were then calculated and analysed.
RESULTS
We identified 80 patients who met the inclusion criteria. Due to loss to follow up, 13 patients were excluded from further analysis, leaving 67 patients for the final analysis. The mean LOI was 14 d (median 15 d; range 3-43 d) with a mean duration of hospital engagement of 67 d (median 57 d; range 10-351 d). Group III (prolonged immobilisation) had a statistically significant worse outcome in comparison to Group I and II (P = 0.04 and P = 0.01 respectively); however, there was no significant difference in the outcome between groups I and II (P = 0.30). No statistically significant difference in the direct medical costs between the groups was identified.
CONCLUSION
The length of elbow immobilization doesn't influence the medical cost; however immobilisation longer than three weeks is associated with persistent stiffness and a less satisfactory clinical outcome.
目的
评估三种不同治疗方案用于单纯性肘关节脱位的治疗管理、临床疗效及成本影响。
方法
经机构委员会批准，我们对2008年1月至2010年12月期间在一级创伤中心接受单纯性肘关节脱位治疗的所有连续患者进行了回顾性研究。根据肘关节固定时间（LOI），患者被分为三组（第一组，<2周；第二组，2 - 3周；第三组，>3周）。当患者能够实现无痛活动范围≥100°（从30°到130°）时，结果被认为是满意的。然后计算并分析每位患者治疗的相关直接医疗成本。
结果
我们确定了80名符合纳入标准的患者。由于失访，13名患者被排除在进一步分析之外，最终分析留下67名患者。平均LOI为14天（中位数15天；范围3 - 43天），平均住院时间为67天（中位数57天；范围10 - 351天）。与第一组和第二组相比，第三组（延长固定）的结果在统计学上显著更差（分别为P = 0.04和P = 0.01）；然而，第一组和第二组之间的结果没有显著差异（P = 0.30）。未发现各组之间直接医疗成本有统计学上的显著差异。
结论
肘关节固定时间不影响医疗成本；然而，固定时间超过三周与持续僵硬和不太满意的临床结果相关。
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