■由于CT成像,胸椎和腰椎的横突骨折(TPF)越来越多地被识别。脊柱服务咨询对于进一步评估和管理很常见。有几项研究表明,有或没有脊柱服务干预的临床结果没有差异。然而,根据我们的知识,没有研究提供额外的成本分析。我们假设孤立的胸腰椎TPF是稳定的损伤。此外,脊柱服务咨询和评估导致医疗费用增加。
■使用2012年1月至2018年8月在圣路易斯大学(SLU)的创伤登记数据确定患者。进行图表和影像学检查以确定脊柱团队是否发现了其他脊柱骨折,这些骨折未包括在初始放射学报告中。与其他脊柱损伤相关的TPF被定义为除了任何其他急性颈椎骨折或脱位之外的一个或多个胸和/或腰椎TPF。胸廓,或腰椎。还对机构特定费用进行了单独的成本分析。
■确定了2012年1月至2018年8月的6182例TPF患者。二百二十八名患者符合纳入本研究的标准。在5例(2.19%)患者中发现了初始放射学报告中未包括的其他脊柱病理学。这些都不需要手术干预。成本分析表明,与脊柱服务干预相关的额外成本总计1,725,360.28美元。我们队列中每位患者的平均费用总计为2,529.85美元。
■这些数据支持,孤立的胸椎和腰椎TPF是稳定的损伤,可能不需要脊柱服务干预,实际上可能代表不必要的经济负担。避免不必要的咨询可以减轻脊柱服务实践中的时间限制,并通过消除患者护理中昂贵的无关干预措施来降低医疗保健成本。
UNASSIGNED: Transverse process fractures (TPF) of the thoracic and lumbar spine have become increasingly identified due to CT imaging. Spine service consultation is common for further evaluation and management. There are several studies that demonstrate no difference in clinical outcome with or without spine service intervention. However, no study to our knowledge provides an additional cost analysis. We hypothesize that isolated thoracolumbar TPF are stable injuries. Furthermore, spine service consultation and evaluation results in increased health care costs.
UNASSIGNED: Patients were identified using trauma registry data at Saint Louis University (SLU) from January 2012 to August 2018. Chart and imaging review was performed to determine if additional spine fractures were identified by the spine team which were not included in the initial radiology report. TPF associated with other spinal injuries were defined as one or more thoracic and/or lumbar TPF in addition to any other acute fracture or dislocation in the cervical, thoracic, or lumbar spine. A separate cost analysis with institution-specific charges was also performed.
UNASSIGNED: Six hundred eighty-two patients with TPF from January 2012 to August 2018 were identified. Two hundred twenty-eight patients met the criteria to be included in this study. Additional spinal pathology that was not included in the initial radiology report was identified in 5 (2.19%) patients, none of which required surgical intervention. Cost analysis demonstrated additional costs associated with spine service intervention totaled $1,725,360.28. Average cost per patient in our cohort summed to $2,529.85.
UNASSIGNED: These data support that isolated TPF of the thoracic and lumbar spine are stable injuries that likely do not require spine service intervention and in fact may represent unnecessary financial burden. Foregoing unnecessary consultation can alleviate time constraints within spine service practices and reduce health care costs by eliminating costly extraneous interventions from the patient\'s care.