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The economic burden of open tibia fractures : a systematic review
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Schade, Alexander T., Khatri, Chetan, Nwankwo, Henry, Carlos, William, Harrison, William J. and Metcalfe, Andrew J. (2021) The economic burden of open tibia fractures : a systematic review. Injury, 52 (6). pp. 1251-1259. doi:10.1016/j.injury.2021.02.022 ISSN 0020-1383.
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WRAP-economic-burden-open-tibia-fractures-systematic-review-Nwankwo-2021.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution Non-commercial No Derivatives 4.0. Download (638Kb) | Preview |
Official URL: http://dx.doi.org/10.1016/j.injury.2021.02.022
Abstract
Background:
Open tibia fractures are a common injury following road traffic collisions and place a large economic burden on patients and healthcare systems. Summarising their economic burden is key to inform policy and help prioritise treatment.
Methods:
All studies were identified from a systematic search of Medline, Embase and the Cochrane Central Register of Controlled Trials. We included any human with a diagnosed open tibia fracture, following any intervention. The primary outcome was any costs reported or patient return to work status. Secondary outcomes included average length of stay, wage loss, absenteeism and complications such as infection, amputation and nonunion. Data was extracted and we performed a descriptive narrative summary.
Results:
We reviewed 1,204 studies from our searches. A total of 34 studies were included from 14 different countries. The average age was 37.7 years old and 76% of the patients were male. 6.5% were Gustilo I, 12% Gustilo II and 82% Gustilo III. Initial direct hospitalisation costs were reported to be between £356 to £126,479 with an average length of stay of 56 days (3.1-244). 89% of participants were working pre-injury, 60% fully returned to work, 17% returned to work part time or changed profession and 22% did not return to work at one-year. The most common complications reported were 22% infection, 11% nonunion and 16% amputation. Mean follow-up duration for the studies was 25 months.
Conclusion:
The economic burden of open tibia fractures varies greatly, but it is costly for both hospitals and patients. The current evidence is predominantly from high-income countries (HICs), especially the USA. Further research is required to investigate the costs of open tibia fractures using validated costing tools, especially in low-income countries (LICs), to help inform and direct policy.
| Item Type: | Journal Article | ||||||||
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| Subjects: | H Social Sciences > HE Transportation and Communications R Medicine > RD Surgery |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Tibia -- Fracture, Traffic safety, Tibia -- Fracture -- Cost effectiveness, Medical care -- Cost effectiveness, Tibia -- Fracture -- Economic aspects | ||||||||
| Journal or Publication Title: | Injury | ||||||||
| Publisher: | Elsevier | ||||||||
| ISSN: | 0020-1383 | ||||||||
| Official Date: | 1 June 2021 | ||||||||
| Dates: |
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| Volume: | 52 | ||||||||
| Number: | 6 | ||||||||
| Page Range: | pp. 1251-1259 | ||||||||
| DOI: | 10.1016/j.injury.2021.02.022 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||
| Date of first compliant deposit: | 17 August 2022 | ||||||||
| Date of first compliant Open Access: | 17 August 2022 | ||||||||
| Is Part Of: | 1 |
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