Abstract：
OBJECTIVE: A consensus definition of fracture related infection (FRI) has been created with the aim of standardising diagnosis and eliminating heterogeneity that prevents accurate comparison between existing studies. FRI remains one of the most challenging complications in musculoskeletal trauma surgery and carries with it a significant cost burden. A review of UK finances has not been completed utilising consensus diagnostic criteria. The goal of this study was to investigate the hospital-associated healthcare cost related to the treatment of FRI within an NHS major trauma centre.
METHODS: Through retrospective case-control analysis, 1240 patients with close fractures were identified. Of those, 21 patients with FRI were compared to 63 uninfected patients. Patients were matched based on fracture location, type of procedure and proximity in age. The costs assessed included hospitalisation, imaging, outpatient consultation, pharmaceuticals and procedure charges. Cost data was retrieved from healthcare resource group (HRG) guidelines, NHS Business Service Authority\'s (NBSA) prescription rates and internal costing.
RESULTS: The FRI group were found to incur a 2.51 increase in total medial healthcare cost compared to the control group (£22,058 vs £8798 [p < 0.001]), which was primarily due to increased procedural costs (£13,020 vs £6291 [p < 0.001]) and length of hospital stay (£7552 vs £2124 [p < 0.001]).
CONCLUSIONS: Whilst diagnosis of FRI has a more rigorous definition following the new consensus, prevalence and cost outcomes are similar to previous studies. Given the deficiency in funding and ongoing challenges of resource allocation to the NHS, it is prudent to incorporate studies such as this into stratifying departmental budgets and quality improvement.
METHODS: III.
METHODS: Through retrospective case-control analysis, 1240 patients with close fractures were identified. Of those, 21 patients with FRI were compared to 63 uninfected patients. Patients were matched based on fracture location, type of procedure and proximity in age. The costs assessed included hospitalisation, imaging, outpatient consultation, pharmaceuticals and procedure charges. Cost data was retrieved from healthcare resource group (HRG) guidelines, NHS Business Service Authority\'s (NBSA) prescription rates and internal costing.
RESULTS: The FRI group were found to incur a 2.51 increase in total medial healthcare cost compared to the control group (£22,058 vs £8798 [p < 0.001]), which was primarily due to increased procedural costs (£13,020 vs £6291 [p < 0.001]) and length of hospital stay (£7552 vs £2124 [p < 0.001]).
CONCLUSIONS: Whilst diagnosis of FRI has a more rigorous definition following the new consensus, prevalence and cost outcomes are similar to previous studies. Given the deficiency in funding and ongoing challenges of resource allocation to the NHS, it is prudent to incorporate studies such as this into stratifying departmental budgets and quality improvement.
METHODS: III.
摘要：
目的：建立了骨折相关感染（FRI）的共识定义，目的是标准化诊断并消除异质性，这妨碍了现有研究之间的准确比较。FRI仍然是肌肉骨骼创伤手术中最具挑战性的并发症之一，并且带来了巨大的成本负担。尚未使用共识诊断标准完成对英国财务的审查。这项研究的目的是调查与NHS主要创伤中心内FRI治疗相关的医院相关医疗费用。
方法：通过回顾性病例对照分析，1240例闭合性骨折患者被确认。其中,将21例FRI患者与63例未感染患者进行比较。患者根据骨折位置进行匹配，手术类型和年龄接近。评估的费用包括住院，成像,门诊咨询,药品和程序费用。成本数据来自医疗资源组(HRG)指南，NHS商业服务管理局(NBSA)的处方率和内部成本计算。
结果：发现与对照组相比，FRI组的医疗总费用增加了2.51（22,058英镑vs8798英镑[p<0.001]），这主要是由于增加了手术费用(13,020英镑vs6291英镑[p<0.001])和住院时间(7552英镑vs2124英镑[p<0.001])。
结论：虽然在新的共识之后，FRI的诊断有更严格的定义，患病率和成本结果与以前的研究相似.鉴于资金不足和NHS资源分配的持续挑战，谨慎的做法是将此类研究纳入部门预算分层和质量改进中。
方法：III.
方法：通过回顾性病例对照分析，1240例闭合性骨折患者被确认。其中,将21例FRI患者与63例未感染患者进行比较。患者根据骨折位置进行匹配，手术类型和年龄接近。评估的费用包括住院，成像,门诊咨询,药品和程序费用。成本数据来自医疗资源组(HRG)指南，NHS商业服务管理局(NBSA)的处方率和内部成本计算。
结果：发现与对照组相比，FRI组的医疗总费用增加了2.51（22,058英镑vs8798英镑[p<0.001]），这主要是由于增加了手术费用(13,020英镑vs6291英镑[p<0.001])和住院时间(7552英镑vs2124英镑[p<0.001])。
结论：虽然在新的共识之后，FRI的诊断有更严格的定义，患病率和成本结果与以前的研究相似.鉴于资金不足和NHS资源分配的持续挑战，谨慎的做法是将此类研究纳入部门预算分层和质量改进中。
方法：III.
