工作年龄段人群桡骨远端骨折手术和保守治疗的病假长度和成本：一项回顾性队列研究。
Sick leave length and the costs of operatively and conservatively treated distal radius fractures in the working age population: a retrospective cohort study.
机构信息
Faculty of Medicine and Health Technology, Tampere University, Tampere, 33520, Finland.
Department of Surgery, Central Finland Central Hospital Nova, Jyvaskyla, Finland.
出版信息
BMC Musculoskelet Disord. 2023 Oct 25;24(1):842. doi: 10.1186/s12891-023-06963-0.
BACKGROUND
Among the working population, a transient loss of working ability due to distal radius fracture (DRF) has a societal impact in terms of sick leave. Non-operative cast immobilization is the most common treatment option for DRF. However, these fractures are increasingly treated operatively. This retrospective cohort study of patients aged 20-64 with DRF compares the effects of different treatment strategies on sick leave length and overall cost of treatment.
METHODS
Multivariable regression analysis was used with treatment modality as an exposure and sick leave length as an outcome. Sick leave data were obtained from a national register. Costs were evaluated by adding the direct cost of the treatment modality to the mean cost of sick leave per patient in different treatment groups.
RESULTS
Of 614 working-age patients with a DRF who were treated at a tertiary hospital in Finland between January 2013 and December 2014, 521 were primarily treated non-operatively with cast immobilization and 93 were primarily operated. Of the primarily non-operatively treated patients, 48 were operated during follow-up. The mean follow-up was 5 years. The median time lost from work after DRF was 55 days (7.9 weeks), and the separated medians by treatment modality were 49 (7 weeks) and 70 days (10 weeks) for conservative and operative treatment, respectively. Multivariable linear regression analyses were performed for those patients who had sick leave (n = 292). Regression analysis also showed that operative treatment correlates with longer sick leave.
CONCLUSIONS
Operative treatment of distal radius fracture led more often to longer time lost from work than conservative treatment. Moreover, due to longer sick leave and the costs of the operation itself, operative treatment is over two times more expensive than conservative treatment.
TRIAL REGISTRATION
retrospectively registered.
背景
在劳动力人群中，由于桡骨远端骨折（DRF）导致的短暂工作能力丧失，会导致病假的社会影响。非手术石膏固定是 DRF 最常见的治疗选择。然而，这些骨折越来越多地采用手术治疗。本研究回顾性分析了 20-64 岁桡骨远端骨折患者，比较了不同治疗策略对病假时间和治疗总费用的影响。
方法
采用多变量回归分析，以治疗方式为暴露因素，病假时间为结局。病假数据来自国家登记处。通过将治疗方式的直接成本与不同治疗组中每位患者的平均病假成本相加，评估了成本。
结果
在芬兰一家三级医院 2013 年 1 月至 2014 年 12 月期间治疗的 614 名处于工作年龄的桡骨远端骨折患者中，521 名患者主要接受非手术石膏固定治疗，93 名患者主要接受手术治疗。在最初接受非手术治疗的患者中，有 48 名患者在随访期间接受了手术。平均随访时间为 5 年。桡骨远端骨折后，工人平均缺勤 55 天（7.9 周），按治疗方式分组的中位数分别为 49 天（7 周）和 70 天（10 周）。对有病假的患者（n=292）进行了多变量线性回归分析。回归分析还表明，手术治疗与更长的病假时间相关。
结论
与保守治疗相比，手术治疗桡骨远端骨折往往导致更长的误工时间。此外，由于病假时间更长，以及手术本身的费用，手术治疗的费用比保守治疗高出两倍多。
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回顾性注册。
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