ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2024
The economic impact of open lower limb fractures in the Netherlands: a cost-of-illness study.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Early orthoplastic coverage reduces fracture-related infections in Gustilo III B/C tibial fractures - a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Pooled it
- Open Fractures in Polytrauma and Non-Polytrauma Patients: Outcomes and Predictive Factors in a Level III Trauma Center.Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca · 2026Article
- Early Flap Reconstruction and Infection Rates in Open Lower Extremity Fractures: A Systematic Review and Meta-analysis.Plastic and reconstructive surgery. Global open · 2025Article
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8 authors.
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Abstract
purposeTo estimate the one-year sum of direct costs related to open lower limb fracture treatment in an academic setting in the Netherlands. The secondary objective was to estimate the impact of deep infection and nonunion on one-year total direct costs.
methodsA multi-center, retrospective cost analysis of open lower limb fractures treated in an academic setting in the Netherlands, between 1 January 2017 and 31 December 2018, was conducted. The costing methodology was based on patient level aggregation using a bottom-up approach. A multiple linear regression model was used to predict the total costs based on Fracture-related-infections, multitrauma, intensive care unit (ICU) admission, Gustilo-Anderson grade and nonunion.
resultsOverall, 70 fractures were included for analysis, the majority Gustilo-Anderson grade III fractures (57%). Median (IQR) one-year hospital costs were €31,258 (20,812-58,217). Costs were primarily attributed to the length of hospital stay (58%) and surgical procedures (30%). The median length of stay was 16 days, with an increase to 50 days in Fracture-related infections. Subsequent costs (46,075 [25,891-74,938] vs. 15,244 [8970-30,173]; p = 0.002), and total hospital costs (90,862 [52,868-125,004] vs. 29,297 [21,784-40,677]; p < 0.001) were significantly higher for infected cases. It was found that Fracture-related infection, multitrauma, and Gustilo-Anderson grade IIIA-C fractures were significant predictors of increased costs.
conclusionIn treatment of open lower limb fractures, deep infection, higher Gustilo-Anderson classification, and multitrauma significantly increase direct hospital costs. Considering the impact of infection on morbidity and total healthcare costs, future research should focus on preventing Fracture-related infections.
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