Financial Toxicity Is Common in Patients After Tibia Fracture.

ABSTRACT

OBJECTIVES: To evaluate the presence of financial distress and identify risk factors for financial toxicity in patients after tibial shaft fracture. DESIGN: A cross-sectional analysis. SETTING: Level I trauma center. PATIENTS All patients within 4 years after tibial shaft fracture (open, closed, or fracture that required flap reconstruction). INTERVENTION Injury-related financial distress. MAIN OUTCOME MEASUREMENTS Financial distress related to the injury, as reported by the patient in a binary question. Financial toxicity using the LIMB-Q, scored from 0 to 100, with higher scores indicating more financial toxicity. RESULTS: Data were collected from 142 patients after tibial shaft fracture [44% closed (n = 62), 41% open (n = 58), and 15% flap (n = 22)]. The mean age was 44 years (SD 17), 61% were men, and the mean time from injury was 15 months. Financial distress was reported by 64% of patients (95% confidence interval, 56% to 72%). Financial toxicity did not differ by fracture severity ( P = 0.12). Medical complications were associated with a 14-point increase in financial toxicity ( P = 0.04). Age older than 65 years (-15 points, P = 0.03) and incomes of $70,000 or more ($70,000-$99,999, -15 points, P = 0.02; >$100,000, -19 points, P < 0.01) protected against financial toxicity. CONCLUSION: We observed financial distress levels more than twice the proportion observed after cancer. Medical complications, lower incomes, and younger age were associated with increased financial toxicity. LEVEL OF EVIDENCE Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.