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.