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肩袖修复手术的临床疗效和直接成本分析。

Clinical outcomes and direct cost analysis of rotator cuff repair surgery.

机构信息

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

Hospital Alvorada Moema, São Paulo, SP, Brazil.

出版信息

Einstein (Sao Paulo). 2024 Aug 23;22:eGS0473. doi: 10.31744/einstein_journal/2024GS0473. eCollection 2024.

Abstract

OBJECTIVE

The purpose of this study was to evaluate the clinical and functional outcomes in patients who underwent surgical treatment for rotator cuff tears using open and arthroscopic techniques, and to evaluate the direct costs involved.

METHODS

Retrospective cohort study with analysis of the data of patients who were referred to two private hospitals in Sao Paulo, Brazil for surgical repair of the rotator cuff from January 2018 to September 2019. Clinical outcomes were assessed using functional scores (SPADI and QuickDASH) and a quality of life questionnaire (EuroQoL). Procedure costs were calculated relative to each hospital's costliest procedure.

RESULTS

Data from 362 patients were analyzed. The mean patient age was 57 years (SD= 10.46), with a slight male predominance (53.9%). Arthroscopic procedures were more common than open procedures (95.6% versus 4.4%). Significant clinical improvement was reported in 84.8% of the patients. The factors associated with increased surgery costs were arthroscopic technique (increase of 29.2%), age (increase of 0.6% per year), and length of stay (increase of 18.9% per day of hospitalization).

CONCLUSION

Rotator cuff repair surgery is a highly effective procedure, associated with favorable clinical outcomes and improvement in life quality, and low rates of complications. Arthroscopic surgery tends to be costlier than open surgery.

摘要

目的

本研究旨在评估采用开放和关节镜技术治疗肩袖撕裂患者的临床和功能结局,并评估相关直接成本。

方法

这是一项回顾性队列研究,对 2018 年 1 月至 2019 年 9 月期间因肩袖撕裂到巴西圣保罗的两家私立医院接受手术修复的患者数据进行了分析。使用功能评分(SPADI 和 QuickDASH)和生活质量问卷(EuroQoL)评估临床结局。手术成本相对于每家医院的最昂贵手术进行计算。

结果

共分析了 362 例患者的数据。患者的平均年龄为 57 岁(标准差=10.46),略以男性为主(53.9%)。关节镜手术比开放手术更为常见(95.6%比 4.4%)。84.8%的患者报告了显著的临床改善。与手术费用增加相关的因素包括关节镜技术(增加 29.2%)、年龄(每年增加 0.6%)和住院时间(住院天数增加 18.9%)。

结论

肩袖修复手术是一种非常有效的治疗方法,可获得良好的临床结局和生活质量改善,且并发症发生率较低。关节镜手术的费用往往高于开放手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aab1/11323837/5c9a82033b88/2317-6385-eins-22-eGS0473-gf01.jpg

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