Hospital-related healthcare expenditure of impending versus completed pathological femur fractures: a propensity score matched study of 265 patients

作者：Tom M. de Groot, Michelle Riyo Shimizu, David Shin, Olivier Q. Groot, Stein J. Janssen, Kevin A. Raskin, Erik T. Newman, Marco Ferrone, Santiago A. Lozano‐Calderón, Joseph H. Schwab, Paul C. Jutte · 发表于：Acta Orthopaedica · 年份：2025 · DOI：10.2340/17453674.2025.43479 · 被引用次数：3 · 研究领域：Management of metastatic bone disease、Bone health and treatments、Sarcoma Diagnosis and Treatment

BACKGROUND AND PURPOSE: The prevalence of metastatic bone disease as well as the accompanying societal costs are expected to increase due to advances in cancer treatment. While the literature suggests that there is economic value in prophylactic stabilization compared with the fixation of completed pathological fractures in long bone metastases, studies are limited by their small sample sizes and insufficient correction for potential confounders. We aimed to evaluate whether prophylactic treatment of an impending femur fracture was associated with lower healthcare costs compared with completed pathologic fractures. We further aimed to compare prophylactic surgical treatment with completed pathological fractures in terms of postoperative complications, discharge disposition, and postoperative length of stay. METHODS: This is a retrospective cohort study with propensity score matching (PSM). We included clinical and financial data for 265 patients who received surgery for impending (n = 161) or completed (n = 104) femoral fractures of metastatic lesions, from 2 affiliated urban tertiary care centers between 2016 and 2020 in the United States. After PSM on 13 variables, including demographics and clinical characteristics, 100 impending fractures were matched with 100 completed fractures. The primary outcome was healthcare costs per episode of care, defined as the total cost from admission to 30 days after discharge. RESULTS: We found no difference in total cost of care between p...