Body Jean-Jacques, Acklin Yves Pascal, Gunther Oliver, Hechmati Guy, Pereira João, Maniadakis Nikos, Terpos Evangelos, Finek Jindrich, von Moos Roger, Talbot Susan, Sleeboom Harm
CHU Brugmann, Université Libre de Bruxelles, Place A.Van Gehuchten 4, 1020 Brussels, Belgium.
Kantonsspital Graubünden, Loëstrasse 170, 7000 Chur, Switzerland.
J Bone Oncol. 2016 Sep 12;5(4):185-193. doi: 10.1016/j.jbo.2016.07.003. eCollection 2016 Nov.
Skeletal-related events (SREs; pathologic fracture [PF], spinal cord compression and radiation or surgery to bone) are common complications of bone metastases or bone lesions and can impose a considerable burden on patients and healthcare systems. In this study, the healthcare resource utilisation (HRU) associated with PFs in patients with bone metastases or lesions secondary to solid tumours or multiple myeloma was estimated in eight European countries.
Eligible patients were identified in Austria, the Czech Republic, Finland, Greece, Poland, Portugal, Sweden and Switzerland. HRU data were extracted from hospital charts from 3.5 months before the index PF (defined as a PF preceded by a 6.5-month period without a SRE) until 3 months after the last SRE during the study period. Changes from baseline in the number and duration of inpatient stays, number of outpatient visits and number of procedures provided were recorded.
Overall, 118 patients with PFs of long bones (those longer than they are wide, e.g. the femur) and 241 patients with PFs of other bones were included. Overall, HRU was greater in patients with long bone PFs than in those with PFs of other bones. A higher proportion of patients with long bone PFs had multiple SREs (79.7%), and more of their SREs were considered to be linked (73.4%) compared with patients with PFs of other bones (51.0% and 47.2%, respectively).
The increased number and duration of inpatient stays for PFs of long bones compared with those for PFs of other bones may be due in part to the requirement for complicated and lengthy rehabilitation in patients with long bone PFs. Implementing strategies to delay or reduce the number of PFs experienced by patients with bone metastases or lesions may therefore reduce the associated HRU and patient burden.
骨相关事件（SREs；病理性骨折[PF]、脊髓压迫以及骨骼的放射治疗或手术）是骨转移或骨病变的常见并发症，会给患者和医疗系统带来相当大的负担。在本研究中，对八个欧洲国家中因实体瘤或多发性骨髓瘤继发骨转移或骨病变的患者发生PFs所涉及的医疗资源利用（HRU）情况进行了估算。
在奥地利、捷克共和国、芬兰、希腊、波兰、葡萄牙、瑞典和瑞士确定符合条件的患者。从索引PF（定义为在6.5个月无SRE的时间段后发生的PF）前3.5个月的医院病历中提取HRU数据，直至研究期间最后一次SRE后3个月。记录住院天数和住院时长、门诊就诊次数以及所提供治疗程序数量相对于基线的变化。
总体而言，纳入了118例长骨PF（长于宽的骨骼，如股骨）患者和241例其他骨骼PF患者。总体而言，长骨PF患者的HRU高于其他骨骼PF患者。与其他骨骼PF患者相比（分别为51.0%和47.2%），长骨PF患者发生多个SRE的比例更高（79.7%），且更多SRE被认为存在关联（73.4%）。
与其他骨骼PF相比，长骨PF患者住院天数和住院时长增加，部分原因可能是长骨PF患者需要复杂且漫长的康复治疗。因此，实施策略以延迟或减少骨转移或骨病变患者经历的PF数量，可能会降低相关的HRU和患者负担。
