Maastricht University Medical Center+, Maastricht, the Netherlands.
Maastricht University, Maastricht, the Netherlands.
Injury. 2022 Feb;53(2):713-718. doi: 10.1016/j.injury.2021.11.012. Epub 2021 Nov 10.
OBJECTIVES: To estimate the economic burden expressed in costs and quality of life of the post-surgical treatment of peri‑ and/or intra-articular fractures in the lower extremity from a societal perspective. DESIGN: This is a quantitative study as it aims to find averages and generalize results to wider populations. The design is a cost-of-illness and quality of life study focusing on costs (in euros), Activities of Daily Living (ADL) and Quality of Life (Qol) in patients with peri‑ and/or intra-articular fractures of the lower extremities. SETTING: Surgically treated trauma patients with peri‑ and/or intra-articular fractures of the lower extremities during 26 weeks follow-up. Patients were included from 4 hospitals in the Netherlands. MAIN OUTCOME MEASURES: Costs, ADL and Quality Adjusted Life Years (QALY). METHODS: Cost of illness was estimated through a bottom-up method. The Dutch Eq-5D-5 L questionnaire was used to calculate utilities while Lower Extremity Functional Scale (LEFS) scores were used as a measure of ADL. Non-parametric bootstrapping was used to test for statistical differences in costs. Subgroup analyses were performed to determine the influence of work status and further sensitivity analyses were performed to test the robustness of the results. RESULTS: Total average societal costs were € 9836.96 over six months. Unexpectedly, total societal and healthcare costs were lower for patients with a paid job relative to patients without. Sensitivity analyses showed that our choice of a societal perspective and the EuroQol as our primary utility measurement tool had a significant effect on the outcomes. The ADL at baseline was respectively; 10.4 and at 26 weeks post-surgery treatment 49.5. The QoL was at baseline respectively; 0.3 and at 26 weeks post-surgery treatment 0.7. These findings are indicative of a significantly improved ADL and QoL (p ≤ 0.05) over time. CONCLUSIONS: This study reveal a substantial economic burden in monetary terms and effect on QoL of patients with peri‑ and/or intra-articular fractures of the lower extremities during 26 weeks follow-up. REGISTRATION: This study was registered in the Dutch Trial Register (NTR6077). Date of registration: 01-09-2016.
目的：从社会角度估算下肢关节周和/或关节内骨折术后治疗的成本和生活质量。 设计：这是一项定量研究，旨在寻找平均值并将结果推广到更广泛的人群。该设计是一项疾病成本和生活质量研究，重点关注成本（欧元）、日常生活活动（ADL）和生活质量（Qol）在下肢关节周和/或关节内骨折患者中的表现。 设置：26 周随访期间接受下肢关节周和/或关节内骨折手术治疗的创伤患者。患者来自荷兰的 4 家医院。 主要观察指标：成本、ADL 和质量调整生命年（QALY）。 方法：采用自下而上的方法估算疾病成本。使用荷兰 EQ-5D-5L 问卷计算效用，同时使用下肢功能量表（LEFS）评分作为 ADL 的衡量标准。使用非参数自举法检验成本的统计学差异。进行亚组分析以确定工作状态的影响，并进行进一步的敏感性分析以检验结果的稳健性。 结果：6 个月内的总社会成本平均为 9836.96 欧元。出乎意料的是，有工作的患者的总社会和医疗成本相对没有工作的患者更低。敏感性分析表明，我们选择社会角度和 EuroQol 作为主要效用测量工具对结果有重大影响。基线时的 ADL 分别为 10.4，手术后 26 周时分别为 49.5。基线时的 QoL 分别为 0.3，手术后 26 周时分别为 0.7。这些发现表明 ADL 和 QoL 随着时间的推移显著改善（p ≤ 0.05）。 结论：这项研究揭示了下肢关节周和/或关节内骨折患者在 26 周随访期间在经济方面的巨大负担以及对生活质量的影响。 注册：本研究已在荷兰临床试验注册中心（NTR6077）注册。注册日期：2016 年 9 月 1 日。
BMC Musculoskelet Disord. 2011-7-6
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