The economic burden of the postoperative management in surgically treated trauma patients with peri- and/or intra-articular fractures of the lower extremities: A prospective multicenter cohort study

P.H.S. Kalmet; M T Andriessen; C V Maduro; N van den Boom; C.P.A. Moens-Oyen; M Hiligsmann; H Janzing; A van der Veen; C Jaspars; J B Sintenie; H.A.M. Seelen; P.R.G. Brink; M Poeze; Smaa Evers

doi:10.1016/j.injury.2021.11.012

The economic burden of the postoperative management in surgically treated trauma patients with peri- and/or intra-articular fractures of the lower extremities: A prospective multicenter cohort study

P.H.S. Kalmet, M T Andriessen, C V Maduro^*, N van den Boom, C.P.A. Moens-Oyen, M Hiligsmann, H Janzing, A van der Veen, C Jaspars, J B Sintenie, H.A.M. Seelen, P.R.G. Brink, M Poeze, Smaa Evers

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVES: To estimate the economic burden expressed in costs and quality of life of the post-surgical treatment of peri‑ and/or intra-articular fractures in the lower extremity from a societal perspective.

DESIGN: This is a quantitative study as it aims to find averages and generalize results to wider populations. The design is a cost-of-illness and quality of life study focusing on costs (in euros), Activities of Daily Living (ADL) and Quality of Life (Qol) in patients with peri‑ and/or intra-articular fractures of the lower extremities.

SETTING: Surgically treated trauma patients with peri‑ and/or intra-articular fractures of the lower extremities during 26 weeks follow-up. Patients were included from 4 hospitals in the Netherlands.

MAIN OUTCOME MEASURES: Costs, ADL and Quality Adjusted Life Years (QALY).

METHODS: Cost of illness was estimated through a bottom-up method. The Dutch Eq-5D-5 L questionnaire was used to calculate utilities while Lower Extremity Functional Scale (LEFS) scores were used as a measure of ADL. Non-parametric bootstrapping was used to test for statistical differences in costs. Subgroup analyses were performed to determine the influence of work status and further sensitivity analyses were performed to test the robustness of the results.

RESULTS: Total average societal costs were € 9836.96 over six months. Unexpectedly, total societal and healthcare costs were lower for patients with a paid job relative to patients without. Sensitivity analyses showed that our choice of a societal perspective and the EuroQol as our primary utility measurement tool had a significant effect on the outcomes. The ADL at baseline was respectively; 10.4 and at 26 weeks post-surgery treatment 49.5. The QoL was at baseline respectively; 0.3 and at 26 weeks post-surgery treatment 0.7. These findings are indicative of a significantly improved ADL and QoL (p ≤ 0.05) over time.

CONCLUSIONS: This study reveal a substantial economic burden in monetary terms and effect on QoL of patients with peri‑ and/or intra-articular fractures of the lower extremities during 26 weeks follow-up.

REGISTRATION: This study was registered in the Dutch Trial Register (NTR6077). Date of registration: 01-09-2016.

Original language	English
Pages (from-to)	713-718
Number of pages	6
Journal	Injury-International Journal of the Care of the Injured
Volume	53
Issue number	2
Early online date	10 Nov 2021
DOIs	https://doi.org/10.1016/j.injury.2021.11.012
Publication status	Published - Feb 2022

Keywords

COMPLICATIONS
COST-OF-ILLNESS
Cost-of-illness
Fracture
Lower extremity
Rehabilitation
Societal perspective
TIBIAL PLATEAU FRACTURES
Trauma
WEIGHT-BEARING

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Cite this

Kalmet, P. H. S., Andriessen, M. T., Maduro, C. V., van den Boom, N., Moens-Oyen, C. P. A., Hiligsmann, M., Janzing, H., van der Veen, A., Jaspars, C., Sintenie, J. B., Seelen, H. A. M., Brink, P. R. G., Poeze, M., & Evers, S. (2022). The economic burden of the postoperative management in surgically treated trauma patients with peri- and/or intra-articular fractures of the lower extremities: A prospective multicenter cohort study. Injury-International Journal of the Care of the Injured, 53(2), 713-718. https://doi.org/10.1016/j.injury.2021.11.012

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title = "The economic burden of the postoperative management in surgically treated trauma patients with peri- and/or intra-articular fractures of the lower extremities: A prospective multicenter cohort study",

abstract = "OBJECTIVES: To estimate the economic burden expressed in costs and quality of life of the post-surgical treatment of peri‑ and/or intra-articular fractures in the lower extremity from a societal perspective.DESIGN: This is a quantitative study as it aims to find averages and generalize results to wider populations. The design is a cost-of-illness and quality of life study focusing on costs (in euros), Activities of Daily Living (ADL) and Quality of Life (Qol) in patients with peri‑ and/or intra-articular fractures of the lower extremities.SETTING: Surgically treated trauma patients with peri‑ and/or intra-articular fractures of the lower extremities during 26 weeks follow-up. Patients were included from 4 hospitals in the Netherlands.MAIN OUTCOME MEASURES: Costs, ADL and Quality Adjusted Life Years (QALY).METHODS: Cost of illness was estimated through a bottom-up method. The Dutch Eq-5D-5 L questionnaire was used to calculate utilities while Lower Extremity Functional Scale (LEFS) scores were used as a measure of ADL. Non-parametric bootstrapping was used to test for statistical differences in costs. Subgroup analyses were performed to determine the influence of work status and further sensitivity analyses were performed to test the robustness of the results.RESULTS: Total average societal costs were € 9836.96 over six months. Unexpectedly, total societal and healthcare costs were lower for patients with a paid job relative to patients without. Sensitivity analyses showed that our choice of a societal perspective and the EuroQol as our primary utility measurement tool had a significant effect on the outcomes. The ADL at baseline was respectively; 10.4 and at 26 weeks post-surgery treatment 49.5. The QoL was at baseline respectively; 0.3 and at 26 weeks post-surgery treatment 0.7. These findings are indicative of a significantly improved ADL and QoL (p ≤ 0.05) over time.CONCLUSIONS: This study reveal a substantial economic burden in monetary terms and effect on QoL of patients with peri‑ and/or intra-articular fractures of the lower extremities during 26 weeks follow-up.REGISTRATION: This study was registered in the Dutch Trial Register (NTR6077). Date of registration: 01-09-2016.",

keywords = "COMPLICATIONS, COST-OF-ILLNESS, Cost-of-illness, Fracture, Lower extremity, Rehabilitation, Societal perspective, TIBIAL PLATEAU FRACTURES, Trauma, WEIGHT-BEARING",

author = "P.H.S. Kalmet and Andriessen, {M T} and Maduro, {C V} and {van den Boom}, N and C.P.A. Moens-Oyen and M Hiligsmann and H Janzing and {van der Veen}, A and C Jaspars and Sintenie, {J B} and H.A.M. Seelen and P.R.G. Brink and M Poeze and Smaa Evers",

year = "2022",

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doi = "10.1016/j.injury.2021.11.012",

language = "English",

volume = "53",

pages = "713--718",

journal = "Injury-International Journal of the Care of the Injured",

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number = "2",

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Kalmet, PHS, Andriessen, MT, Maduro, CV, van den Boom, N, Moens-Oyen, CPA, Hiligsmann, M, Janzing, H, van der Veen, A, Jaspars, C, Sintenie, JB, Seelen, HAM, Brink, PRG, Poeze, M & Evers, S 2022, 'The economic burden of the postoperative management in surgically treated trauma patients with peri- and/or intra-articular fractures of the lower extremities: A prospective multicenter cohort study', Injury-International Journal of the Care of the Injured, vol. 53, no. 2, pp. 713-718. https://doi.org/10.1016/j.injury.2021.11.012

The economic burden of the postoperative management in surgically treated trauma patients with peri- and/or intra-articular fractures of the lower extremities: A prospective multicenter cohort study. / Kalmet, P.H.S.; Andriessen, M T; Maduro, C V et al.
In: Injury-International Journal of the Care of the Injured, Vol. 53, No. 2, 02.2022, p. 713-718.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - The economic burden of the postoperative management in surgically treated trauma patients with peri- and/or intra-articular fractures of the lower extremities

T2 - A prospective multicenter cohort study

AU - Kalmet, P.H.S.

AU - Andriessen, M T

AU - Maduro, C V

AU - van den Boom, N

AU - Moens-Oyen, C.P.A.

AU - Hiligsmann, M

AU - Janzing, H

AU - van der Veen, A

AU - Jaspars, C

AU - Sintenie, J B

AU - Seelen, H.A.M.

AU - Brink, P.R.G.

AU - Poeze, M

AU - Evers, Smaa

PY - 2022/2

Y1 - 2022/2

N2 - OBJECTIVES: To estimate the economic burden expressed in costs and quality of life of the post-surgical treatment of peri‑ and/or intra-articular fractures in the lower extremity from a societal perspective.DESIGN: This is a quantitative study as it aims to find averages and generalize results to wider populations. The design is a cost-of-illness and quality of life study focusing on costs (in euros), Activities of Daily Living (ADL) and Quality of Life (Qol) in patients with peri‑ and/or intra-articular fractures of the lower extremities.SETTING: Surgically treated trauma patients with peri‑ and/or intra-articular fractures of the lower extremities during 26 weeks follow-up. Patients were included from 4 hospitals in the Netherlands.MAIN OUTCOME MEASURES: Costs, ADL and Quality Adjusted Life Years (QALY).METHODS: Cost of illness was estimated through a bottom-up method. The Dutch Eq-5D-5 L questionnaire was used to calculate utilities while Lower Extremity Functional Scale (LEFS) scores were used as a measure of ADL. Non-parametric bootstrapping was used to test for statistical differences in costs. Subgroup analyses were performed to determine the influence of work status and further sensitivity analyses were performed to test the robustness of the results.RESULTS: Total average societal costs were € 9836.96 over six months. Unexpectedly, total societal and healthcare costs were lower for patients with a paid job relative to patients without. Sensitivity analyses showed that our choice of a societal perspective and the EuroQol as our primary utility measurement tool had a significant effect on the outcomes. The ADL at baseline was respectively; 10.4 and at 26 weeks post-surgery treatment 49.5. The QoL was at baseline respectively; 0.3 and at 26 weeks post-surgery treatment 0.7. These findings are indicative of a significantly improved ADL and QoL (p ≤ 0.05) over time.CONCLUSIONS: This study reveal a substantial economic burden in monetary terms and effect on QoL of patients with peri‑ and/or intra-articular fractures of the lower extremities during 26 weeks follow-up.REGISTRATION: This study was registered in the Dutch Trial Register (NTR6077). Date of registration: 01-09-2016.

AB - OBJECTIVES: To estimate the economic burden expressed in costs and quality of life of the post-surgical treatment of peri‑ and/or intra-articular fractures in the lower extremity from a societal perspective.DESIGN: This is a quantitative study as it aims to find averages and generalize results to wider populations. The design is a cost-of-illness and quality of life study focusing on costs (in euros), Activities of Daily Living (ADL) and Quality of Life (Qol) in patients with peri‑ and/or intra-articular fractures of the lower extremities.SETTING: Surgically treated trauma patients with peri‑ and/or intra-articular fractures of the lower extremities during 26 weeks follow-up. Patients were included from 4 hospitals in the Netherlands.MAIN OUTCOME MEASURES: Costs, ADL and Quality Adjusted Life Years (QALY).METHODS: Cost of illness was estimated through a bottom-up method. The Dutch Eq-5D-5 L questionnaire was used to calculate utilities while Lower Extremity Functional Scale (LEFS) scores were used as a measure of ADL. Non-parametric bootstrapping was used to test for statistical differences in costs. Subgroup analyses were performed to determine the influence of work status and further sensitivity analyses were performed to test the robustness of the results.RESULTS: Total average societal costs were € 9836.96 over six months. Unexpectedly, total societal and healthcare costs were lower for patients with a paid job relative to patients without. Sensitivity analyses showed that our choice of a societal perspective and the EuroQol as our primary utility measurement tool had a significant effect on the outcomes. The ADL at baseline was respectively; 10.4 and at 26 weeks post-surgery treatment 49.5. The QoL was at baseline respectively; 0.3 and at 26 weeks post-surgery treatment 0.7. These findings are indicative of a significantly improved ADL and QoL (p ≤ 0.05) over time.CONCLUSIONS: This study reveal a substantial economic burden in monetary terms and effect on QoL of patients with peri‑ and/or intra-articular fractures of the lower extremities during 26 weeks follow-up.REGISTRATION: This study was registered in the Dutch Trial Register (NTR6077). Date of registration: 01-09-2016.

KW - COMPLICATIONS

KW - COST-OF-ILLNESS

KW - Cost-of-illness

KW - Fracture

KW - Lower extremity

KW - Rehabilitation

KW - Societal perspective

KW - TIBIAL PLATEAU FRACTURES

KW - Trauma

KW - WEIGHT-BEARING

U2 - 10.1016/j.injury.2021.11.012

DO - 10.1016/j.injury.2021.11.012

M3 - Article

C2 - 34809922

SN - 0020-1383

VL - 53

SP - 713

EP - 718

JO - Injury-International Journal of the Care of the Injured

JF - Injury-International Journal of the Care of the Injured

IS - 2

ER -

Kalmet PHS, Andriessen MT, Maduro CV, van den Boom N, Moens-Oyen CPA, Hiligsmann M et al. The economic burden of the postoperative management in surgically treated trauma patients with peri- and/or intra-articular fractures of the lower extremities: A prospective multicenter cohort study. Injury-International Journal of the Care of the Injured. 2022 Feb;53(2):713-718. Epub 2021 Nov 10. doi: 10.1016/j.injury.2021.11.012