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- W2783294183 abstract "Objectives To determine if open reduction and internal fixation (ORIF) is more cost-effective than hemiarthroplasty (HA) in the management of proximal humerus fracture. Design Retrospective cohort study with cost-effectiveness analysis. Setting Tertiary referral center in Rochester, NY. Patients/participants The records of 459 consecutive patients in whom a proximal humerus fracture was treated surgically at our institution between the years 2002 and 2012 were studied retrospectively. We identified 30 consecutive patients with a mean follow-up of 60.3 months (13.6–134.5 months) of which 15 patients underwent primary ORIF and another 15 underwent primary HA for the management of head-splitting fracture or fracture-dislocation of the proximal humerus. Intervention HA or ORIF for the management of proximal humerus fracture. Main outcome measurements SF-36 scores were converted to utility weights, and a cost-effectiveness model was designed to evaluated ORIF and HA. Results Given the baseline assumptions, ORIF was slightly more costly but also more effective (0.75 quality-adjusted life years [QALY] vs 0.67 QALY) than HA. The incremental cost-effectiveness ratio (ICER) was $5319/QALY for ORIF compared to HA, which is less than the cost-effectiveness standard utilized based on a willingness to pay of $50,000/QALY. Conclusions Compared to HA, ORIF is the more cost-effective approach for the surgical management of complex proximal humerus fractures. These data are limited by patient selection which would impact the relative utility scores. These results suggest that ORIF should be considered the preferable surgical approach given payer and patient perspectives. Level of Evidence: This is a Level III retrospective, cohort therapeutic study." @default.
- W2783294183 created "2018-01-26" @default.
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- W2783294183 date "2018-01-01" @default.
- W2783294183 modified "2023-10-18" @default.
- W2783294183 title "Cost-effectiveness of Open Reduction and Internal Fixation Compared With Hemiarthroplasty in the Management of Complex Proximal Humerus Fractures" @default.
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- W2783294183 doi "https://doi.org/10.1177/2471549217751453" @default.
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