The environmental impact of tibial fracture-related infections

Healthcare is an energy and resource intensive sector, imparting significant environmental burden on a global scale. Minimizing avoidable resource utilization within hospitals can help achieve environmental sustainability amongst healthcare systems. Reducing surgical complications, such as tibial fracture-related infections (FRIs), which require resource-rich healthcare activities can be an impactful approach to achieve environmental sustainability, while maintaining or advancing patient health outcomes. The objective of this study was to leverage healthcare resource utilization data to evaluate the environmental impact of tibial FRIs amongst patients undergoing surgical treatment.

An environmental model was developed using inputs informed from a systematic literature review and synthesized in a meta-analysis. Healthcare resource utilization data were used to compare the environmental impact for patients with and without a tibial FRI in relation to key healthcare activities such as hospital length of stay, reoperations, antibiotic therapy, and emergency room visits. A subgroup analysis was conducted to understand the environmental implications of more severe open fractures complicated by FRI, to supplement the mixed (open/closed) fracture population presented in the base case. Sustainability data was obtained from the Sustainable Healthcare Coalition's Care Pathways Guidance document and other published sources. Outcomes assessed were greenhouse gas (GHG) emissions, water use, and waste generated.

The results of this environmental impact assessment demonstrated that effectively preventing tibial FRIs can lead to a substantial reduction in carbon footprint. Preventing one FRI may result in an average reduction of 1025.3 kg CO₂, water savings of 1778.6 m³, and waste savings of 79.4 kg. Results of the subgroup analysis, which included patients with open tibial fractures, further substantiated the environmental impact associated with tibial FRIs.

Preventing tibial FRIs may have a substantial environmental impact leading to a reduction in GHG emissions, water use, and waste generation. Interventions that reduce the incidence of tibial FRIs may contribute to the global goal of environmental sustainability. The results of this study are intended to empower healthcare providers and decision makers within the healthcare sector to make informed decisions that contribute to improved environmental sustainability, while maintaining or advancing patient health outcomes.