The hospital costs of complications following colonic resection surgery: A retrospective cohort study

Louis, Maleck; Johnston, Samuel A; Чурилов, Леонид; Ma, Ronald; Marhoon, Nada; Burgess, Adele; Christophi, Christopher; Weinberg, Laurence

doi:10.1016/j.amsu.2020.03.013

Cited by 10 publications

(14 citation statements)

References 28 publications

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“…In our study, CVD grade II complications only had an additive effect on hospital costs in the 50th and 75th cost percentiles. Although there are no similar studies on small bowel resection surgery to compare these results, similar studies have been undertaken for other major abdominal surgeries [ 2 – 4 ]. Our results are similar to what has been found following rectal resection.…”

Section: Discussionmentioning

confidence: 99%

“…For example, Johnston et al [ 3 ] found that minor postoperative complications (i.e., CVD grade I) did not significantly increase hospital costs following rectal resection. However, studies investigating the relationship between postoperative complications and hospital costs following colonic and liver resections demonstrated different results [ 2 , 4 ]. These studies found a significant association between minor complications and hospital costs.…”

Section: Discussionmentioning

confidence: 99%

“…Major complications are a consistent driver of higher hospital costs across studies [ 2 – 4 , 21 ]. Our study further highlighted the importance of targeting complication severity and count.…”

Section: Discussionmentioning

confidence: 99%

“…In turn, these decisions can help guide cost-reduction strategies. Although some studies have evaluated the detailed costs of complications associated with abdominal surgery [1][2][3][4], few studies have explored the health costs of complications following small bowel resection surgery. The incidence of small intestine cancer is increasing.…”

Section: Introductionmentioning

confidence: 99%

“…The numbers of patients with 1, 2, 3, and � 4 complications were 59 (20.8%), 49 (17.2%), 56 (19.7%), and 120 (42.3%), respectively. The median [IQR] number of complications per patient in the PC group was 3[2][3][4][5]. Of the PC patients, 59 (20.8%) were CVD grade I, 137 (48.2%) CVD grade II, 21 (7.4%) CVD grade III, and 44 (15.5%) CVD grade IV.…”

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Postoperative complications and hospital costs following small bowel resection surgery

et al. 2020

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Background Postoperative complications after major gastrointestinal surgery are a major contributor to hospital costs. Thus, reducing postoperative complications is a key target for cost-containment strategies. We aimed to evaluate the relationship between postoperative complications and hospital costs following small bowel resection. Methods Postoperative complications were recorded for 284 adult patients undergoing major small bowel resection surgery between January 2013 and June 2018. Complications were defined and graded according to the Clavien-Dindo classification system. In-hospital cost of index admission was calculated using an activity-based costing methodology; it was reported in US dollars at 2019 rates. Regression modeling was used to investigate the relationships among a priori selected perioperative variables, complications, and costs. Findings The overall complication prevalence was 81.6% (95% CI: 85.7-77.5). Most complications (69%) were minor, but 22.9% of patients developed a severe complication (Clavien-Dindo grades III or IV). The unadjusted median total hospital cost for patients with any complication was 70% higher than patients without complications (median [IQR]

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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Postoperative complications and hospital costs following small bowel resection surgery

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Cost of postoperative complications of lower anterior resection for rectal cancer: a nationwide registry study of 15,187 patients

et al. 2022

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Purpose To assess the increase in hospital costs associated with postoperative complications after lower anterior resection (LAR) for rectal cancer. Methods The subjects of this retrospective analysis were patients who underwent elective LAR surgery between April, 2015 and March, 2017, collected from a Japanese nationwide gastroenterological surgery registry linked to hospital-based claims data. We evaluated total and category-specific hospitalization costs based on the level of postoperative complications categorized using the Clavien–Dindo (CD) classification. We assessed the relative increase in hospital costs, adjusting for preoperative factors and hospital case volume. Results We identified 15,187 patients (mean age 66.8) treated at 884 hospitals. Overall, 71.8% had no recorded complications, whereas 7.6%, 10.8%, 9.0%, 0.6%, and 0.2% had postoperative complications of CD grades I–V, respectively. The median (25th–75th percentiles) hospital costs were $17.3 K (16.1–19.3) for the no-complications group, and $19.1 K (17.3–22.2), $21.0 K (18.5–25.0), $27.4 K (22.4–33.9), $41.8 K (291–618), and $22.7 K (183–421) for the CD grades I–V complication groups, respectively. The multivariable model identified that complications of CD grades I–V were associated with 11%, 21%, 61%, 142%, and 70% increases in in-hospital costs compared with no complications. Conclusions Postoperative complications and their severity are strongly associated with increased hospital costs and health-care resource utilization. Implementing strategies to prevent postoperative complications will improve patients’ clinical outcomes and reduce hospital care costs substantially.

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The Hidden Pandemic: the Cost of Postoperative Complications

Ludbrook

2021

Curr Anesthesiol Rep

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The hospital costs of complications following colonic resection surgery: A retrospective cohort study

Cited by 10 publications

References 28 publications

Postoperative complications and hospital costs following small bowel resection surgery

Postoperative complications and hospital costs following small bowel resection surgery

Cost of postoperative complications of lower anterior resection for rectal cancer: a nationwide registry study of 15,187 patients

The Hidden Pandemic: the Cost of Postoperative Complications

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