title: Development of Compartment Syndrome Negatively Impacts Length of Stay and Cost After Tibia Fracture.
abstract: OBJECTIVE
  To quantify the impact of compartment syndrome in the setting of tibial shaft fracture on hospital length of stay (LOS) and total hospital charges.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  All New York State hospital admissions from 2001 to 2011, as recorded by the New York Statewide Planning and Research Cooperative System database.
  
  
  METHODS
  Thirty three thousand six hundred twenty-nine inpatients with isolated open or closed fractures of the tibia and/or fibula (AO/OTA 41-43). Six hundred ninety-two patients developed a compartment syndrome in the setting of tibia fracture. All patients were filtered to ensure none had other complications or medical comorbidities that would increase LOS or total hospital charges.
  
  
  METHODS
  Fasciotomy and delayed closure in patients who developed a compartment syndrome.
  
  
  METHODS
  Hospital LOS (days) and total inflation-adjusted hospital charges.
  
  
  RESULTS
  A total of 33,629 patients with tibial shaft fracture were included in the study. There were 32,937 patients who did not develop a compartment syndrome. For this group, the mean LOS was 6 days, and the mean inflation-adjusted hospital charges were $34,000. Patients who developed compartment syndrome remained in-house for an average of 14 days with average charges totaling $79,000. These differences were highly significant for both lengths of stay and hospital charges (P < 0.001).
  
  
  CONCLUSIONS
  Besides the obvious physical detriment experienced by patients with compartment syndrome, there is also a significant economic impact to the healthcare system. Compartment syndrome after a tibial fracture more than doubles LOS and total hospital charges. These findings highlight the need for a standardized care algorithm aimed toward efficiently and adequately treating acute compartment syndrome. Such an algorithm would optimize cost of care and presumably decrease LOS.
  
  
  METHODS
  Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, NY; and †Department of Orthopaedic Surgery, Jamaica Hospital Medical Center, Jamaica, NY.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Crespo
authors.forename: Arthur
authors.initials: A
authors.lastname: Manoli
authors.forename: Sanjit R
authors.initials: SR
authors.lastname: Konda
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Egol
mesh_terms: D000465:Algorithms; D016022:Case-Control Studies; D003161:Compartment Syndromes / Q000209:etiology* / Q000601:surgery; D062109:Dermatologic Surgical Procedures / Q000191:economics* / Q000379:methods; D000071938:Fasciotomy; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics*; D008297:Male; D019637:Orthopedic Procedures / Q000191:economics* / Q000379:methods; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000150:complications* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome