A claims-based current clinical course of the post-treatment period after a unilateral elbow fracture.

OBJECTIVE

The aim of this paper was to determine a claims-based timeline of unilateral elbow fracture recovery including the effect of comorbidities and post-treatment complications on recovery.

METHODS

This study utilized data from the IBM MarketScan database (2015-2018) to assess costs and recovery timelines after unilateral elbow fracture treatment. All costs are reported in U.S. dollars and reflect prices during the 2015-2018 period. Costs examined included: (i) index surgery/treatment, (ii) complication surgery, (iii) revision or salvage surgeries, (iv) non-operative hospitalization, (v) motion restoring surgery and (vi) additional elbow-related outpatient surgery. Costs of related physician visits, physical/occupational therapy and diagnostic radiology were also incorporated. The impact of comorbidities-diabetes, obesity, peripheral vascular disease, and cardiovascular disease-was evaluated. Additionally, data on re-hospitalizations, with or without further surgery, were analyzed to understand complications after the initial treatment. Perioperative complications including joint fibrosis/contracture, infection, and pulmonary embolus were also reported.

RESULTS

Index surgery/treatment median cost and length of post-treatment recovery (from index surgery/treatment to last physical/occupational therapy claim) was $4,494 ($872-$10,444) and 102.5 days (36-480 days), respectively. A total of 59% of patients completed their post-treatment period in 6 months with 41% of patients taking longer. Patients who required a complication surgery had median recovery times and costs that increased three- and seven-fold, respectively, in comparison to those without complication surgeries. Comorbidities added 66-113 days to recovery. Peripheral and cardio-vascular disease coincided with 1.7-3 times higher post-treatment costs.

CONCLUSION

Comorbidities and complications following elbow fracture treatment lead to substantial increases in both costs and recovery durations. Understanding the typical recovery timeline after elbow fracture treatment, as well as the variations in outlier patients, can assist in optimizing recovery management and guiding appropriate interventions.