Proefschrift

PWB insurgically treated trauma patients with peri- and/or intra-articular fractures of the lower extremities is cost effective 109 RWB groups. Characteristics of patients in the PWB and RWB group are summarized in Table 8.1. Table 8.1 Baseline characteristics and in hospital outcome of the PWB and RWB groups. PWB (N=53) RWB (N=53) Total (N=106) p Female, N 27 (50.9%) 27 (50.9%) 54 (50.9%) 1.00 Median age (IQR), years 55.0 (38.5-65.0) 60.0 (47.0-67.0) 58.0 (43.5-66.3) 0.27 Employee, N 27 (50.9%) 26 (49.1%) 53 (50.0%) 0.99 ASA, N I, II III > 49 (92.5%) 4 (7.5%) 44 (83.0%) 9 (17%) 93 (87.7%) 13 (12.3%) 0.14 Median Charlson score (IQR) 1 (0-3) 2 (1-3) 2 (0-3) 0.03 Fracture type, N: Pelvic Acetabular Tibial plateau Pilon Calcaneal 7 (13.2%) 5 (9.4%) 16 (30.2%) 17 (32.1%) 8 (15.1%) 1 (1.9%) 3 (5.7%) 28 (52.8%) 12 (22.6%) 9 (17.0%) 8 (7.5%) 8 (7.5%) 44 (41.5%) 29 (27.4%) 17 (16%) 0.18 In hospital outcome: 2 or more procedures (%) Median length of stay (IQR), in days 9 (17.0) 7.0 (2.0-15.5) 8 (15.1) 5.0 (2.0-11.5) 17 (16.0) 6.0 (2.0-14.0) 0.57 0.24 Abbreviation: PWB, permissive weight bearing; RWB, restricted weight bearing; N, number of subjects; ASA, American Society of Anesthesiologists; IQR, interquartile range. A flow diagram of the participants is shown in Figure 8.1. After a follow-up of 26 weeks post-surgery, the overall response rate of the patients’ self-perceived outcome levels at all measurement points was 99.8% (N=1 patient refused to fill out the patient self-perceived outcome questionnaires at week 26). ADL, as measured with the LEFS, and quality of life, as measured with the SF-12 and the EQ-5D, were all significantly increased in the PWB group compared to the RWB group (p<0.01) over a period of 26-weeks post-surgery. Furthermore, full weight bearing was achieved faster in the PWB group compared to the usual RWB regime (p<0.01). The utility scores derived from the LEFS are presented in table 2; the mean LEFS in the PWB group was significantly higher at all follow-up moments compared to the RWB group. The sensitivity analysis between patients with paid job and patients without paid job showed a significant difference between the PWB and RWB groups at follow-up week 6, 12 and week 26. The mean utility score for both the PWB and RWB groups increased significantly at follow-up week 12 and 26. Furthermore, significant differences in QALY’s between the groups were found (see Table 8.2).

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