背景:全髋关节置换术(THA)是原发性和继发性终末期髋关节骨关节炎(OA)最常见的治疗方法。接受原发性THA的所有患者中几乎有20%患有双侧髋关节OA,因此,将需要在接下来的几年中进行对侧手术。这项研究的目的是评估一阶段双边THA(1-BTHA)与两阶段双边THA(2-BTHA)相比的成本效益和可靠性,在低风险患者中,进行前路微创手术(AMIS)。
方法:通过将年度费用报告除以住院次数来获得单个患者的费用,考虑两个程序的诊断相关组(DRG)。然后,检查了16例接受1-BTHA的患者和8例接受2-BTHA的患者。手术前和出院前的血红蛋白(Hb)值,观察输血率及术后并发症发生情况。
结果:程序费用分为不同的亚组:住院前,手术室,住院,术后随访和其他费用。1-BTHA总成本为5.754,82€,而执行2-BTHA的费用为7.624,32€。然而,考虑到DRG报销,1-BTHA后医院的利润率低于2-BTHA后的利润率(6.346,18欧元对9.261,68欧元)。1-BTHA和2-BTHA的手术时间没有显着差异(141,13±26,1分钟vs164,8±44,3分钟;p=0,111)。两组显示出Hb下降的统计学差异(4,8±1,3g/dlvs3,3±0,9;p=0,001),尽管输血率没有差异。两组均无进一步并发症发生。
结论:这项研究表明,在精心挑选的患者中,与2-BTHA相比,使用AMIS进行的1-BTHA是一种经济高效且安全的技术,导致较短的OR时间,LOS和降低总体成本。
方法:III.
BACKGROUND: Total hip arthroplasty (THA) is the most common treatment for primary and secondary end-stage hip osteoarthritis (OA). Almost 20% of all patients undergoing primary THA suffer from bilateral hip OA and, consequently, will need a contralateral procedure to be performed in the following years. The aim of this study is to evaluate the cost-effectiveness and the reliability of one-stage bilateral THA (1-BTHA) compared to two-stage bilateral THA (2-BTHA), in low-risk patients, performed with anterior minimally invasive surgery (AMIS).
METHODS: Single patient\'s costs were obtained by dividing the annual costs report by the number of hospitalizations, considering the diagnosis related group (DRG) of the two procedures. Then, 16 patients undergoing 1-BTHA and 8 undergoing 2-BTHA were examined. Hemoglobin (Hb) values before surgery and before discharge, transfusion rate and the occurrence of post-operative complications were observed.
RESULTS: Procedural costs were divided in different subgroups: pre-hospitalization, operating room, hospital stay, post-operative follow-up and other costs. 1-BTHA total costs amount to 5.754,82€, while performing 2-BTHA costs 7.624,32€. However, considering DRG reimbursement, the hospital\'s profit margin following 1-BTHA is lower than that following 2-BTHA (6.346,18€ versus 9.261,68€). Surgical time was found not to be significantly different between 1-BTHA and 2-BTHA (141,13 ± 26,1 min vs 164,8 ± 44,3 min; p = 0,111). The two groups showed a statistically significant difference in Hb decrease (4,8 ± 1,3 g/dl vs 3,3 ± 0,9; p = 0,001), despite no variances in transfusion rate. No further complications were observed in either group.
CONCLUSIONS: This study demonstrates how, in carefully selected patients, 1-BTHA performed with AMIS is a cost-effective and safe technique compared to 2-BTHA, resulting in a shorter OR time, LOS and lower overall costs.
METHODS: III.