Total cost of hospitalization after internal fixation of intertrochanteric fracture / 中华创伤骨科杂志

ABSTRACT

Objective To analyze the factors influencing the total cost of hospitalization after internal fixation of intertrochanteric fracture.Methods Enrolled in this study were 142 patients with intertrochanteric fracture who had been treated at our department between March 2013 and August 2014.They were 54 men and 88 women,aged from 24 to 95 years (average 69.8 years).Intramedullary fixation was adopted in 135 cases while extramedullary fixation in 7.By AO classification,32 cases were type A 1,75 type A2 and 35 type A3.We analyzed their demographic data,fracture-associated factors,bleeding-associated factors and surgery-associated factors.For univariate analysis,the independent sample t test was performed between 2 groups.One-Way ANOVA analysis was performed among several groups.For multivariate analysis,multivariate linear regression analysis was performed.P ＜ 0.05 was regarded as statistically significant.Results The independent sample test revealed that the total cost of hospitalization for those with preoperative deep venous thrombosis (6.9 ± 1.0 × 105 (￥)) was significantly higher than for those without (5.0 ± 0.8 × 105 (￥)) and the total cost for those undergoing intramedullary fixation (5.5 ± 1.2 × 105 (￥)) was significantly higher than for those undergoing extramedullary fixation (4.4 ±0.7 × 105 (￥)) (P ＜ 0.05).The multiple linear regression analyses showed that preoperative deep venous thrombosis (t =11.750,P ＜ 0.001),perioperative transfusion (t =2.803,P =0.006),hospital stay (t =5.949,P ＜ 0.001) and intraoperative blood loss (t =2.885,P =0.005) were the independent factors influencing the total cost of hospitalization.Conclusions Preoperative deep venous thrombosis,perioperative transfusion,intraoperative blood loss,and hospital stay may influence the total cost of hospitalization for patients undergoing internal fixation of intertrochanteric fracture.More attention should be paid to control of the total cost of hospitalization in addition to ensuring the perioperative life safety.