Alexander M Crespo1, Arthur Manoli, Sanjit R Konda, Kenneth A Egol. 1. *Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, NY; and †Department of Orthopaedic Surgery, Jamaica Hospital Medical Center, Jamaica, NY.
Abstract
OBJECTIVES: To quantify the impact of compartment syndrome in the setting of tibial shaft fracture on hospital length of stay (LOS) and total hospital charges. DESIGN: Retrospective case-control study. SETTING: All New York State hospital admissions from 2001 to 2011, as recorded by the New York Statewide Planning and Research Cooperative System database. PATIENTS: Thirty three thousand six hundred twenty-nine inpatients with isolated open or closed fractures of the tibia and/or fibula (AO/OTA 41-43). Six hundred ninety-two patients developed a compartment syndrome in the setting of tibia fracture. All patients were filtered to ensure none had other complications or medical comorbidities that would increase LOS or total hospital charges. INTERVENTION: Fasciotomy and delayed closure in patients who developed a compartment syndrome. MAIN OUTCOME MEASURE: Hospital LOS (days) and total inflation-adjusted hospital charges. RESULTS: A total of 33,629 patients with tibial shaft fracture were included in the study. There were 32,937 patients who did not develop a compartment syndrome. For this group, the mean LOS was 6 days, and the mean inflation-adjusted hospital charges were $34,000. Patients who developed compartment syndrome remained in-house for an average of 14 days with average charges totaling $79,000. These differences were highly significant for both lengths of stay and hospital charges (P < 0.001). CONCLUSIONS: Besides the obvious physical detriment experienced by patients with compartment syndrome, there is also a significant economic impact to the healthcare system. Compartment syndrome after a tibial fracture more than doubles LOS and total hospital charges. These findings highlight the need for a standardized care algorithm aimed toward efficiently and adequately treating acute compartment syndrome. Such an algorithm would optimize cost of care and presumably decrease LOS. LEVEL OF EVIDENCE: Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.
OBJECTIVES: To quantify the impact of compartment syndrome in the setting of tibial shaft fracture on hospital length of stay (LOS) and total hospital charges. DESIGN: Retrospective case-control study. SETTING: All New York State hospital admissions from 2001 to 2011, as recorded by the New York Statewide Planning and Research Cooperative System database. PATIENTS: Thirty three thousand six hundred twenty-nine inpatients with isolated open or closed fractures of the tibia and/or fibula (AO/OTA 41-43). Six hundred ninety-two patients developed a compartment syndrome in the setting of tibia fracture. All patients were filtered to ensure none had other complications or medical comorbidities that would increase LOS or total hospital charges. INTERVENTION: Fasciotomy and delayed closure in patients who developed a compartment syndrome. MAIN OUTCOME MEASURE: Hospital LOS (days) and total inflation-adjusted hospital charges. RESULTS: A total of 33,629 patients with tibial shaft fracture were included in the study. There were 32,937 patients who did not develop a compartment syndrome. For this group, the mean LOS was 6 days, and the mean inflation-adjusted hospital charges were $34,000. Patients who developed compartment syndrome remained in-house for an average of 14 days with average charges totaling $79,000. These differences were highly significant for both lengths of stay and hospital charges (P < 0.001). CONCLUSIONS: Besides the obvious physical detriment experienced by patients with compartment syndrome, there is also a significant economic impact to the healthcare system. Compartment syndrome after a tibial fracture more than doubles LOS and total hospital charges. These findings highlight the need for a standardized care algorithm aimed toward efficiently and adequately treating acute compartment syndrome. Such an algorithm would optimize cost of care and presumably decrease LOS. LEVEL OF EVIDENCE: Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Authors: Augustine M Saiz; Alexandria C Wellman; Dustin Stwalley; Philip Wolinsky; Anna N Miller Journal: J Orthop Trauma Date: 2020-05 Impact factor: 2.512
Authors: Piia Suomalainen; Toni-Karri Pakarinen; Ilari Pajamäki; Minna K Laitinen; Heikki-Jussi Laine; Jussi P Repo; Ville M Mattila Journal: Scand J Surg Date: 2021-06-02 Impact factor: 2.360