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Acute and long-term costs of 268 peripheral nerve injuries in the upper extremity

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  • Konstantin D Bergmeister
  • Luisa Große-Hartlage
  • Simeon C Daeschler
  • Patrick Rhodius
  • Arne Böcker
  • Marius Beyersdorff
  • Axel Olaf Kern
  • Ulrich Kneser
  • Leila Harhaus

Abstract

Background: Peripheral nerve injury in the upper extremity is linked to high socioeconomic burden, yet cost-analyses are rare and from small cohorts. The objective of this study was to determine the costs and long-term socioeconomic effects of peripheral nerve injuries in the upper extremity in Germany. Methods: We analyzed data of 250 patients with 268 work-related upper extremity nerve injuries from acute treatment to long-term follow-up on rehabilitation, sick-leave and disability-pension. Results: Patients were on average 39.9±14.2 years old, male (85%) and mean inpatient treatment was 7±6 days. Location of nerve was 8% (N = 19) proximal to the wrist, 26% (N = 65) at the wrist and metacarpus, and 66% (N = 166) at phalangeal level. Acute in-patient treatment for (single) median nerve injury accounted for 66% with hospital reimbursement of 3.570€, ulnar nerve injury for 24% and 2.650€ and radial nerve injury for 10% and 3.166€, all including finger nerve injuries. The remaining were combined nerve injuries, with significantly higher costs, especially if combined with tendon 5.086€ or vascular injury 4.886€. Based on location, nerve injuries proximal to the wrist averaged 5.360±6.429€, at the wrist and metacarpus 3.534±2.710€ and at the phalangeal level 3.418±3.330€. 16% required rehabilitation with average costs of 5.842€ and stay of 41±21 days. Sick leave was between 11–1109 days with an average of 147 days with socioeconomic costs of 197€/day, equaling on average 17.640€. 30% received a mean yearly disability pension of 3.187€, that would account to 102.167€ per lifetime. Conclusion: This large German patient sample indicates that nerve injury has a major impact on function and employment, resulting in significant health care costs. Both proximal and distal nerve injuries led to long-term disability, subsequent sick-leave and in 30% to permanent disability pension. These data are determined to support future studies and health economical work on prevention, treatment and rehabilitation of these often small injuries with great consequences.

Suggested Citation

  • Konstantin D Bergmeister & Luisa Große-Hartlage & Simeon C Daeschler & Patrick Rhodius & Arne Böcker & Marius Beyersdorff & Axel Olaf Kern & Ulrich Kneser & Leila Harhaus, 2020. "Acute and long-term costs of 268 peripheral nerve injuries in the upper extremity," PLOS ONE, Public Library of Science, vol. 15(4), pages 1-12, April.
    • Handle: RePEc:plo:pone00:0229530
    DOI: 10.1371/journal.pone.0229530
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    1. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement," PharmacoEconomics, Springer, vol. 31(5), pages 361-367, May.
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    1. Ena Bula-Oyola & Juan-Manuel Belda-Lois & Rosa Porcar-Seder & Álvaro Page, 2021. "Effectiveness of electrophysical modalities in the sensorimotor rehabilitation of radial, ulnar, and median neuropathies: A meta-analysis," PLOS ONE, Public Library of Science, vol. 16(3), pages 1-26, March.

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