Department of Orthopaedics, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Department of Epidemiology, and Program in Quantitative Biomedical Sciences, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA.
Bone Joint J. 2018 Sep;100-B(9):1227-1233. doi: 10.1302/0301-620X.100B9.BJJ-2017-1488.R1.
The aims of this study were to quantify health state utility values (HSUVs) after a tibial fracture, investigate the effect of complications, to determine the trajectory in HSUVs that result in these differences and to quantify the quality-adjusted life years (QALYs) experienced by patients.
This is an analysis of 2138 tibial fractures enrolled in the Fluid Lavage of Open Wounds (FLOW) and Study to Prospectively Evaluate Reamed Intramedullary Nails in Patients with Tibial Fractures (SPRINT) trials. Patients returned for follow-up at two and six weeks and three, six, nine and 12 months. Short-Form Six-Dimension (SF-6D) values were calculated and used to calculate QALYs.
Compared with those who did not have a complication, those with a complication treated either nonoperatively or operatively had lower HSUVs at all times after two weeks. The HSUVs improved in all patients with the passage of time. However, they did not return to the remembered baseline preinjury values nor to US age-adjusted normal values by 12 months after the injury.
While the acute fracture and complications may have resolved clinically, the detrimental effect on a patient's quality of life persists up to 12 months after the injury. Cite this article: Bone Joint J 2018;100-B:1227-33.
本研究旨在量化胫骨骨折后的健康状态效用值（HSUV），探讨并发症的影响，确定导致这些差异的 HSUV 轨迹，并量化患者所经历的质量调整生命年（QALY）。
这是对 Fluid Lavage of Open Wounds（FLOW）和 Study to Prospectively Evaluate Reamed Intramedullary Nails in Patients with Tibial Fractures（SPRINT）两项试验中 2138 例胫骨骨折患者的分析。患者在两周和六周以及三个月、六个月、九个月和十二个月时进行随访。采用简短式健康量表六维度（SF-6D）进行评估，并计算 QALY。
与无并发症患者相比，两周后无论接受非手术或手术治疗的并发症患者在所有时间点的 HSUV 均较低。所有患者的 HSUV 随时间推移而改善。然而，12 个月后，HSUV 仍未恢复至受伤前的记忆基线水平，也未恢复至美国年龄校正的正常值。
尽管急性骨折和并发症在临床上可能已得到解决，但对患者生活质量的不利影响仍持续至受伤后 12 个月。
Bone Joint J 2018;100-B:1227-33.
