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document
Hemiarthroplasty compared to internal fixation with percutaneous cannulated screws as treatment of displaced femoral neck fractures in the elderly : cost-utility analysis performed alongside a randomized , controlled trial . UNLABELLED We estimated the cost-effectiveness of hemiarthroplasty compared to internal fixation for elderly patients with displaced femoral neck fractures . Over 2 years , patients treated with hemiarthroplasty gained more quality-adjusted life years than patients treated with internal fixation . In addition , costs for hemiarthroplasty were lower . Hemiarthroplasty was thus cost effective . INTRODUCTION Estimating the cost utility of hemiarthroplasty compared to internal fixation in the treatment of displaced femoral neck fractures in the elderly . METHODS A cost-utility analysis ( CUA ) was conducted alongside a clinical randomized controlled trial at a university hospital in Norway ; 166 patients , 124 ( 75 % ) women with a mean age of 82 years were randomized to either internal fixation ( n = 86 ) or hemiarthroplasty ( n = 80 ) . Patients were followed up at 4 , 12 , and 24 months . Health-related quality of life was assessed with the EQ-5D , and in combination with time used to calculate patients ' quality-adjusted life years ( QALYs ) . Resource use was identified , quantified , and valued for direct and indirect hospital costs and for societal costs . Results were expressed in incremental cost-effectiveness ratios . RESULTS Over the 2-year period , patients treated with hemiarthroplasty gained 0.15-0.20 more QALYs than patients treated with internal fixation . For the hemiarthroplasty group , the direct hospital costs , total hospital costs , and total costs were non-significantly less costly compared with the internal fixation group , with an incremental cost of €2,731 ( p = 0.81 ) , €2,474 ( p = 0.80 ) , and €14,160 ( p = 0.07 ) , respectively . Thus , hemiarthroplasty was the dominant treatment . Sensitivity analyses by bootstrapping supported these findings . CONCLUSION Hemiarthroplasty was a cost-effective treatment . Trial registration , NCT00464230 .
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Intervention_Physical
Hemiarthroplasty
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Intervention_Physical
internal fixation with percutaneous cannulated screws
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Intervention_Surgical
hemiarthroplasty
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Intervention_Surgical
internal fixation .
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Intervention_Surgical
hemiarthroplasty
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Intervention_Surgical
Hemiarthroplasty
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Intervention_Surgical
hemiarthroplasty
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Intervention_Surgical
internal fixation
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Outcome_Other
cost-effectiveness
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Outcome_Other
quality-adjusted life years
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Outcome_Other
direct hospital costs , total hospital costs , and total costs
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Participant_Condition
displaced femoral neck fractures in the elderly :