| アブストラクト | INTRODUCTION: The clinical and economic burden of clavicle fractures in England is not well documented. This study evaluated rates of surgical treatment, post-surgical complications, reoperations and costs in patients with clavicle fractures using the Clinical Practice Research Datalink (CPRD) database. METHODS: CPRD data were linked to National Health Service Hospital Episode Statistics data. Patients with a diagnosis of clavicle fracture between 2010-2018 were selected in CPRD (date of fracture = index date). Of those, patients with surgical intervention within 180 days from index fracture were identified. Rates of post-surgical complications (i.e., infection, non-union, and mal-union), reoperations (for device removal or for postoperative complications), post-operative costs and median time to reoperations were evaluated up to 2 years after surgery. RESULTS: 21,340 patients with clavicle fractures were identified (mean age 35.0 years(standard deviation (SD): 26.5), 66.7% male). Surgery was performed on 672 patients (3.2% of total cohort) at an average 17.1 (SD: 25.2) days post-fracture. Complications (i.e., infection, non-union, or malunion) affected 8.1% of surgically treated clavicle fracture patients; the rate of infection was 3.5% (95% CI, 1.7%- 5.2%), non-union 4.4% (95% CI, 2.4%-6.5%), and mal-union 0.3% (95% CI, 0%-0.7%). Adjusting for age, gender, comorbidities and time to surgery, the all-cause reoperation rate was 20.2% (13.2%-30.0%) and the adjusted rate of reoperation for implant removal was 17.0% (10.7%-25.9%)-84% of all-cause reoperations were thus performed for implant removal. Median time to implant removal was 254 days. The mean cost of reoperations for all causes was pound5,000. The most expensive reoperations were for cases that involved infection (mean pound6,156). CONCLUSIONS: Complication rates following surgical clavicle fracture care averaged 8.1%. However, reoperation rates exceed 20%, the vast majority of reoperations being performed for device removal. Technologies to alleviate secondary device removal surgeries would address a significant clinical unmet need. |
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| ジャーナル名 | BMC musculoskeletal disorders |
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| 投稿日 | 2022/2/11 |
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| 投稿者 | Wolf, Simone; Chitnis, Abhishek S; Manoranjith, Anandan; Vanderkarr, Mollie; Plaza, Javier Quintana; Gador, Laura V; Holy, Chantal E; Sparks, Charisse; Lambert, Simon M |
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| 組織名 | Synthes GmbH, Zuchwil, Switzerland.;Medical Devices Epidemiology, Johnson & Johnson, New Brunswick, NJ, USA.;Mu Sigma, Bangalore, India.;DePuy Synthes, Inc., West Chester, PA, USA.;Johnson and Johnson, Madrid, Spain.;Johnson and Johnson GmbH, Neuss, Germany.;choly1@its.jnj.com.;University College London Hospital, London, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/35139854/ |
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