ACS in tibial facture patients linked with doubled costs, length of stay

Issue: November 2014

Physicians should proceed with caution when making a determination of acute compartment syndrome following tibia fracture as this diagnosis carries significantly increased costs and length of stay, based on a study presented at a recent meeting.

“The diagnosis of compartment syndrome results in a two-fold increase in the length of stay [and of] potential health care costs,” Alexander M. Crespo, BS, of NYU Hospital for Joint Diseases Hospital for Joint Diseases, said.

Across patients in the study, mean length of stay reached 14 days among those diagnosed with acute compartment syndrome (ACS), compared to 6 days for those with who did not develop ACS. Crespo and his colleagues also found the mean charges for ACS hospital treatment reached $79,000 compared with a mean cost of $34,000 for tibial fracture treatment alone.

Costly care

Crespo suggested the additional costs could be attributed to the standard treatment protocol for ACS which includes intravenous antibiotics, vacuum-assisted closure and fasciotomy, a multi-step process which must be completed while in the hospital.

Crespo urged restraint on the part of physicians when considering a diagnosis of ACS if indications for the syndrome were questionable, bearing in mind the potential for unwarranted medical costs. During his presentation, he surmised that ACS may be unnecessarily diagnosed based on fear of malpractice suits, potential for poor patient outcomes and lack of quality study methods, suggesting that information has been lacking on the true impact of the diagnosis.

Need for better modalities

This lack of information served as the impetus for Crespo and his colleagues to launch the study and provide a clearer picture of the impact of ACS on health care costs. Using data from the New York Statewide Planning and Research Cooperative System, the researchers identified 33,629 patients who were treated for tibia fracture between 2001 and 2011. Among the study group, 692 patients were diagnosed with ACS.

Crespo noted that the study was limited by the information available through the database, and recommended “diagnostic ‘state of the art’ modalities are needed.” – by Katie Pfaff

Reference:

Crespo A. Paper #74. Presented at the International Society for Fracture Repair Congress. May 14-17, 2014. New York.

For more information:

Alexander M. Crespo, BS, can be reached at NYU Hospital for Joint Diseases, 301 East 17th St., New York, NY 10003; email: alexander_crespo@nymc.edu.

Disclosure: Crespo has no relevant financial disclosures.