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难民的骨科创伤手术与医院成本分析;叙利亚内战的影响

Orthopedic trauma surgery and hospital cost analysis in refugees; the effect of the Syrian civil War.

作者信息

Duramaz Altuğ, Bilgili Mustafa Gökhan, Bayram Berhan, Ziroğlu Nezih, Bayrak Alkan, Avkan Mustafa Cevdet

机构信息

Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.

出版信息

Int Orthop. 2017 May;41(5):877-884. doi: 10.1007/s00264-016-3378-x. Epub 2017 Jan 7.

DOI:10.1007/s00264-016-3378-x
PMID:28064351
Abstract

PURPOSE

The aim of this study was to evaluate the musculoskeletal injury types, injury mechanisms, surgical techniques and treatment costs of Syrian refugees.

METHODS

Totally 158 patients (67 female, 91 male) treated in our clinic in 34 months period between January 2012 and October 2014 were included in the study. The mean age of the patients was 39.3 years (range: 18-82 years). The patients were evaluated for age, gender, mechanism of injury, location and type of fracture, presence of accompanying injuries, injury severity score, surgical technique, complications, mortality/morbidity and treatment cost.

RESULTS

The injuries were more frequently reported in lower extremities, upper extremities and axial skeleton, respectively. Blunt trauma was significantly higher in upper extremity injuries compared with the other types of injuries (p = 0.001). Fractures were most commonly reported in foot/ankle region and in males, hand/wrist fractures were significantly higher than that of the females. Plate fixation of upper extremity fractures and intramedullary nailing in lower extremity fractures were the most commonly preferred treatment modalities. The mean hospitalization period of patients was 5.6 days and the mean treatment cost was 3844 Turkish Liras (TL).

CONCLUSIONS

In this study, it was shown that there was a statistically significant increase in the cost of health expenses in patients with fall from heights or gunshot wound, with fractures in axial skeleton or with the ISS score between 16 and 66. The cost rise was associated with worse prognosis, complications, intensive care treatments and prolonged hospitalization periods.

摘要

目的

本研究旨在评估叙利亚难民的肌肉骨骼损伤类型、损伤机制、手术技术及治疗费用。

方法

纳入2012年1月至2014年10月期间在我院接受治疗的158例患者(女性67例,男性91例)。患者的平均年龄为39.3岁(范围:18 - 82岁)。对患者进行年龄、性别、损伤机制、骨折部位和类型、是否存在伴随损伤、损伤严重程度评分、手术技术、并发症、死亡率/发病率及治疗费用等方面的评估。

结果

损伤分别更常见于下肢、上肢和轴向骨骼。与其他类型损伤相比,上肢损伤中钝器伤显著更高(p = 0.001)。骨折最常发生在足/踝部,男性手部/腕部骨折明显高于女性。上肢骨折的钢板固定和下肢骨折的髓内钉固定是最常用的治疗方式。患者的平均住院时间为5.6天,平均治疗费用为3844土耳其里拉(TL)。

结论

本研究表明,高处坠落或枪伤、轴向骨骼骨折或损伤严重程度评分在16至66之间的患者,医疗费用有统计学意义的显著增加。费用增加与预后较差、并发症、重症监护治疗及住院时间延长有关。

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