背景:由于人口老龄化导致的假体周围感染(PJI)的增加正在稳步增加关节置换术的数量和治疗成本。本研究分析了欧洲PJI用于全髋关节置换术(THA)和全膝关节置换术(TKA)的直接医疗成本。
方法:数据库PubMed,Scopus,Embase,科克伦,和谷歌学者进行了系统的筛选,以确定PJI在欧洲的直接成本。进一步分析了定义关节位点和所执行程序的出版物。计算清创的平均直接医疗费用,抗生素和植入物滞留(DAIR),髋关节和膝关节PJI的一阶段和两阶段修正,分别。成本根据通货膨胀率进行了调整,并以美元(USD)报告。
结果:在1,374份合格出版物中,经过摘要和全文审查后,最终分析中包含了12份手稿。对于所有类型的膝关节PJI翻修手术,平均直接费用为32,933美元。包括清创在内的平均直接治疗成本,抗生素,PJI后TKA的植入物保留率(DAIR)为$19,476。对于TKA的两阶段修订,平均总成本为37,980美元。对于所有类型的髋关节PJI手术,平均直接住院费用为28,904美元。对于臀部DAIR,确定了一阶段和两阶段治疗的平均费用为$7,120,$44,594和$42,166,分别。
结论:假体周围关节感染与大量直接医疗费用相关。由于PJI成本的详细报告很少且质量有限,迫切需要有关PJI治疗费用的更详细财务数据。
BACKGROUND: The rise of periprosthetic joint infections (PJIs) due to aging populations is steadily increasing the number of arthroplasties and treatment costs. This study analyzed the direct health care costs of PJI for total hip arthroplasty and total knee arthroplasty (TKA) in Europe.
METHODS: The databases PubMed, Scopus, Embase, Cochrane, and Google Scholar were systematically screened for direct costs of PJI in Europe. Publications that defined the joint site and the procedure performed were further analyzed. Mean direct health care costs were calculated for debridement, antibiotics, and implant retention (DAIR), one-stage, and 2-stage revisions for hip and knee PJI, respectively. Costs were adjusted for inflation rates and reported in US-Dollar (USD).
RESULTS: Of 1,374 eligible publications, 12 manuscripts were included in the final analysis after an abstract and full-text review. Mean direct costs of $32,933 were identified for all types of revision procedures for knee PJI. The mean direct treatment cost including DAIR for TKA after PJI was $19,476. For 2-stage revisions of TKA, the mean total cost was $37,980. For all types of hip PJI procedures, mean direct hospital costs were $28,904. For hip DAIR, one-stage and 2-stage treatment average costs of $7,120, $44,594, and $42,166 were identified, respectively.
CONCLUSIONS: Periprosthetic joint infections are associated with substantial direct health care costs. As detailed
reports on the cost of PJI are scarce and of limited quality, more detailed financial data on the cost of PJI treatment are urgently required.