Clinical and Economic Burden of Autologous Skin Grafting for Nonthermal Full-Thickness Wounds Across Care Settings: A US Retrospective Claims Study.

IF 4.7 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Therapy Pub Date : 2026-08-10 DOI:10.1007/s12325-026-03747-5

Lauren A Do, Mihail Samnaliev, Matthew Sussman, Roselle E Crombie, Lisa J Gould

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引用次数: 0

Abstract

Introduction: The clinical and economic burden among patients with non-thermal full-thickness wounds (NFTW) resulting from trauma or surgery and undergoing autologous skin grafts is not well characterized. Assessing burden of care can inform treatment choice, evaluation of emerging wound therapies, and payer coverage decisions.

Methods: Clarivate's Real-world Data Repository^® national claims database between 01/01/2019 and 08/31/2024 was used to select patients aged ≥ 15 years with a primary NFTW diagnosis who underwent an autologous skin graft procedure (index). Separate cohorts were analyzed according to the site of care where the index procedure was performed (inpatient, outpatient hospital, office/clinic). Kaplan-Meier estimates of the 90-day post-index adverse outcome rates, select adjunct procedures, and select medication use were generated. All-cause 12-month healthcare resource utilization (HRU) and costs [in 2024 United States (US) dollars] were also estimated.

Results: Of the 26,117 patients with a NFTW, the mean age was 59.3 years and 43.3% were female. During the 12-month pre-index period 41.2% were smokers, 32.0% were obese, 31.8% had diabetes or diabetes-related comorbidities, and 21.5% were malnourished. Drug or alcohol abuse (15.6%), frailty (13.6%), and autoimmune diseases/immunodeficiency (10.4%) were also common. Traumatic wounds accounted for 56.1% and surgical wounds for 29.7% of all cases. Within 90 days, regrafting and graft failure occurred in 7.6% and 4.9% of the inpatient cohort, 3.4% and 3.1% of the outpatient hospital cohort, and 3.5% and 0.1% of the office/clinic cohort, respectively. Total mean annual costs were $266,231 (standard deviation (SD) = $458,484] per patient in the inpatient, $62,619 (SD = $132,510) in the outpatient hospital, and $14,261 (SD = $36,894) in the office/clinic cohorts with an average all-cohort cost of $128,959 (SD = $306,485).

Conclusion: Patients receiving autologous skin grafts for NFTW are medically complex with high rates of complications and significant costs, highlighting the need for novel interventions or adjunct therapies to reduce the associated clinical and economic burden.

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非热全层伤口自体皮肤移植的临床和经济负担：美国回顾性索赔研究。

导读：创伤或手术导致的非热全层创面（NFTW）患者接受自体皮肤移植的临床和经济负担尚不清楚。评估护理负担可以为治疗选择、评估新出现的伤口疗法和付款人覆盖决定提供信息。方法：使用2019年1月1日至2024年8月31日期间Clarivate的Real-world Data Repository®国家索赔数据库，选择年龄≥15岁，原发诊断为NFTW并接受自体皮肤移植手术的患者（index）。根据执行指标程序的护理地点（住院、门诊医院、办公室/诊所）对单独的队列进行分析。生成了90天后不良结果发生率、选择辅助手术和选择药物使用的Kaplan-Meier估计。还估计了全因12个月医疗保健资源利用率（HRU）和成本[以2024年美元计]。结果：在26117例NFTW患者中，平均年龄为59.3岁，其中43.3%为女性。在调查前的12个月里，41.2%的人吸烟，32.0%的人肥胖，31.8%的人患有糖尿病或糖尿病相关的合并症，21.5%的人营养不良。药物或酒精滥用（15.6%）、虚弱（13.6%）和自身免疫性疾病/免疫缺陷（10.4%）也很常见。外伤性伤口占56.1%，外科伤口占29.7%。在90天内，再植和移植物失败的发生率分别为住院组的7.6%和4.9%，门诊组的3.4%和3.1%，办公室/诊所组的3.5%和0.1%。住院患者的总平均年成本为266,231美元（标准差(SD) = 458,484美元），门诊医院为62,619美元（SD = 132,510美元），办公室/诊所队列为14,261美元（SD = 36,894美元），全队列平均成本为128,959美元（SD = 306,485美元）。结论：接受自体皮肤移植治疗NFTW的患者医学复杂，并发症发生率高，费用高，需要新的干预措施或辅助治疗来减轻相关的临床和经济负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.