Changing Epidemiology of Distal Femur Fractures: Increase in Geriatric Fractures and Rates of Distal Femur Replacement

Author:

DeKeyser GrahamORCID,Thorne Tyler,Martin Brook I.,Haller Justin M.

Abstract

Introduction: Distal femur fractures (DFFs) are associated with high complication and mortality rates in the elderly. Using the National Inpatient Sample and Medicare data, we describe trends in the incidence of DFFs by fixation type and associated healthcare costs. Methods: Annual population rates and volume of inpatient DFFs were estimated using Poisson regression with the US Census as a denominator. We used Current Procedural Terminology codes in Medicare patients to determine episode-of-care cost by treatment, classified as intramedullary nail, open reduction and internal fixation, and distal femur arthroplasty (DFR). Results: The annual incidence of DFFs in the United States is approximately 27.4 per 100,000. Admission for DFFs increased from 2002 to 2020, with the highest volume and rate in those aged 85 years and older. DFF incidence increased (1.95×) from 142 per 1 million (95% CI: 140 to 144) in 2006 to 281 per 1 million (95% CI: 278-284) in 2019. From 2012 to 2019, the percentage of DFFs treated by intramedullary nail increased from 6.8% to 8.4%, open reduction and internal fixation decreased from 89.9% to 76.6%, and DFR increased from 3.3% to 14.9%. DFR cost was significantly greater than other treatment choices across all years for initial inpatient admission costs and 90-day episode-of-care costs (all P < 0.0001). Conclusion: DFF volume has increased in the past 20 years, predominantly in elderly patients. Greater than 4.5× increase was observed in the proportion of geriatric DFFs treated with DFR during this study period. The total cost of DFR treatment was consistently greater than other surgical treatments.

Funder

Agency for Healthcare Research and Quality

Publisher

Ovid Technologies (Wolters Kluwer Health)

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3