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Extracapsular hip fracture management: Cost-consequences analysis of two alternative operative methods

Published online by Cambridge University Press:  09 April 2008

Vassiliki V. Papakonstantinou ,
Daphne Kaitelidou ,
Kassiani D. Gkolfinopoulou ,
Olga Ch. Siskou ,
Theodoros Papapolychroniou ,
Panagiotis Baltopoulos  and
Lycourgos Liaropoulos
Vassiliki V. Papakonstantinou
Affiliation:
University of Athens
Daphne Kaitelidou
Affiliation:
University of Athens
Kassiani D. Gkolfinopoulou
Affiliation:
University of Peloponnese and Hellenic Center for Disease Control & Prevention
Olga Ch. Siskou
Affiliation:
University of Athens
Theodoros Papapolychroniou
Affiliation:
NIMTS Hospital
Panagiotis Baltopoulos
Affiliation:
University of Athens and KAT Hospital
Lycourgos Liaropoulos
Affiliation:
University of Athens
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Abstract

Objectives: The aim of this prospective study was to perform a cost and outcome comparison between two alternative operative techniques (osteosynthesis and hemiarthroplasty) used in the treatment of elderly patients with unstable trochanteric hip fracture.

Materials and Methods: One hundred seventy-three trochanteric hip fracture patients were followed-up for 1 year after surgery. For each operative technique, hospital treatment's cost per patient was computed. Mortality and complication rate in-hospital and at specific time points after surgery were used as outcome measures. Patients' functional level before and after hip fracture was estimated according to their mobility and ability to perform basic and instrumental activities of daily living.

Results: The cost for patients undergoing osteosynthesis reached €1,931 per case, whereas for those treated with hemiarthroplasty reached €3,719 per case (2001 rates). There was no statistically significant difference regarding in-hospital mortality and complication rate, as well as mortality and complication rate 1 year after surgery, between the two patient groups.

Conclusions: The quite similar performance of the two operative techniques suggests that cost could be the key factor for choosing between them. However, it is critical that many more randomized studies, with larger sample sizes and wider follow-up time periods should be conducted.

Keywords

CostExtracapsular hip fractureHemiarthroplastyMortalityOsteosynthesis
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 24 , Issue 2 , April 2008 , pp. 221 - 227
Copyright
Copyright © Cambridge University Press 2008

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