1
|
Bauer HH, Sahmoud A, Rhodes SP, Sheyn D. Inpatient Hospital Costs and Route of Hysterectomy for Management of Benign Uterine Disease in the 90-Day Global Billing Period. Obstet Gynecol 2024:00006250-990000000-01097. [PMID: 38870524 DOI: 10.1097/aog.0000000000005643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/02/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE To compare inpatient hospital costs and complication rates within the 90-day global billing period among routes of hysterectomy. METHODS The Premier Healthcare Database was used to identify patients who underwent hysterectomy between 2000 and 2020. Current Procedural Terminology codes were used to group patients based on route of hysterectomy. Comorbidities and complications were identified using International Classification of Diseases codes. Fixed, variable, and total costs for inpatient care were compared. Fixed costs consist of costs that are set for the case, such as operating room time or surgeon costs. Variable costs include disposable and reusable items that are billed additionally. Total costs equal fixed and variable costs combined. Data were analyzed using analysis of variance, t test, and χ2 test, as appropriate. Factors independently associated with increased total costs were assessed using linear mixed effects models. Multivariate logistic regression was performed to evaluate associations between the route of surgery and complication rates. RESULTS A cohort of 400,977 patients were identified and grouped by route of hysterectomy. Vaginal hysterectomy demonstrated the lowest inpatient total cost ($6,524.00 [interquartile range $4,831.60, $8,785.70]), and robotic-assisted laparoscopic hysterectomy had the highest total cost ($9,386.80 [interquartile range $6,912.40, $12,506.90]). These differences persisted with fixed and variable costs. High-volume laparoscopic and robotic surgeons (more than 50 cases per year) had a decrease in the cost difference when compared with costs of vaginal hysterectomy. Abdominal hysterectomy had a higher rate of complications relative to vaginal hysterectomy (adjusted odds ratio [aOR] 1.52, 95% CI, 1.39-1.67), whereas laparoscopic (aOR 0.85, 95% CI, 0.80-0.89) and robotic-assisted (aOR 0.92, 95% CI, 0.84-1.00) hysterectomy had lower rates of complications compared with vaginal hysterectomy. CONCLUSION Robotic-assisted hysterectomy is associated with higher surgical costs compared with other approaches, even when accounting for surgeon volume. Complication rates are low for minimally invasive surgery, and it is unlikely that the robotic-assisted approach provides an appreciable improvement in perioperative outcomes.
Collapse
Affiliation(s)
- Hope H Bauer
- Division of Urogynecology, Department of Urology, the Department of Obstetrics and Gynecology, and the Department of Urology, University Hospitals, Cleveland, Ohio
| | | | | | | |
Collapse
|
2
|
Le HD, Wolinska JM, Baertschiger RM, Himidan SA. Complication Is Inevitable, but Suffering is Optional-Psychological Aspects of Dealing with Complications in Surgery. Eur J Pediatr Surg 2023; 33:181-190. [PMID: 36948212 DOI: 10.1055/s-0043-1767830] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
Surgical complications remain common in health care and constitute a significant challenge for hospitals, surgeons, and patients. While they cause significant physical, financial, and psychological harm to patients and their families, they also heavily burden the involved physicians. This phenomenon, known as the "second victim," results in negative short and long-term physical, cognitive, and psychological consequences on the surgeon. In this review, we explored the intricate connections between the surgeons' emotional response to adverse events concerning the patient outcome, perceived peer reaction, and existing social and institutional support systems. Using a selective literature review coupled with personal experiences, we propose a model of this complex interaction and suggest specific interventions to ameliorate the severity of response within this framework. The institution of the proposed interventions may improve the psychological well-being of surgeons facing complications and promote a cultural shift to better support physicians when they occur.
Collapse
Affiliation(s)
- Hau D Le
- Division of Pediatric Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
| | - Justyna M Wolinska
- Division of Pediatric Surgery, Department of Surgery, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
| | - Reto M Baertschiger
- Division of General and Thoracic Surgery, Department of Surgery, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sharifa A Himidan
- Division of General and Thoracic Surgery, Department of Surgery, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Surgery, Humber River Hospital, Toronto, Ontario, Canada
| |
Collapse
|
3
|
Weinberg L, Ratnasekara V, Tran AT, Kaldas P, Neal-Williams T, D’Silva MR, Hua J, Yip S, Lloyd-Donald P, Fletcher L, Ma R, Perini MV, Nikfarjam M, Lee DK. The Association of Postoperative Complications and Hospital Costs Following Distal Pancreatectomy. Front Surg 2022; 9:890518. [PMID: 35711711 PMCID: PMC9195500 DOI: 10.3389/fsurg.2022.890518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/13/2022] [Indexed: 12/09/2022] Open
Abstract
Background Understanding the financial implications associated with the complications post-distal pancreatectomy (DP) may be beneficial for the future optimisation of postoperative care pathways and improved cost-efficiency. The primary outcome of this retrospective study was the characterisation of the additional cost associated with postoperative complications following DP. The secondary outcome was the estimation of the prevalence, type and severity of complications post-DP and the determination of which complications were associated with higher costs. Methods Postoperative complications were retrospectively examined for 62 adult patients undergoing distal pancreatectomy at an Australian university hospital between January 2012 and July 2021. Complications were defined and graded using the Clavien–Dindo (CVD) classification system. In-hospital cost of index admission was calculated using an activity-based costing methodology and was reported in US dollars at 2021 rates. Regression modelling was used to investigate the relationships among selected perioperative variables, complications and costs. Results 45 patients (72.6%) experienced one or more postoperative complications. The median (IQR) hospital cost in US dollars was 31.6% greater in patients who experienced complications compared to those who experienced no complications ($40,717.8 [27,358.0–59,834.3] vs. $30,946.9 [23,910.8–46,828.1]). Costs for patients with four or more complications were 43.5% higher than for those with three or fewer complications (p = 0.015). Compared to patients with no complications, the median hospital costs increased by 17.1% in patients with minor complications (CVD grade I/II) and by 252% in patients who developed major complication (i.e., CVD grade III/IV) complications. Conclusion Postoperative complications are a key target for cost-containment strategies. Our findings demonstrate a high prevalence of postoperative complications following distal pancreatectomy with number and severity of postoperative complications being associated with increased hospital costs. (Registered in the Australian New Zealand Clinical Trials Registry [No. ACTRN12622000202763]).
Collapse
Affiliation(s)
- Laurence Weinberg
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
- Department of Critical Care, The University of Melbourne, Austin Health, Heidelberg, Australia
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
- Correspondence: Laurence Weinberg
| | | | - Anthony T. Tran
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
| | - Peter Kaldas
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
| | | | | | - Jackson Hua
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
| | - Sean Yip
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
| | | | - Luke Fletcher
- Department of Anaesthesia, Austin Health, Heidelberg, Australia
- Data Analytics Research and Evaluation (DARE) Centre, Austin Health, Heidelberg, Australia
| | - Ronald Ma
- Business Intelligence Unit, Austin Health, Heidelberg, Australia
| | - Marcos V. Perini
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
| | - Mehrdad Nikfarjam
- Department of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia
| | - Dong-Kyu Lee
- Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| |
Collapse
|
4
|
Kumamaru H, Kakeji Y, Fushimi K, Ishikawa KB, Yamamoto H, Hashimoto H, Ono M, Iwanaka T, Marubashi S, Gotoh M, Seto Y, Kitagawa Y, Miyata H. Cost of postoperative complications of lower anterior resection for rectal cancer: a nationwide registry study of 15,187 patients. Surg Today 2022; 52:1766-1774. [PMID: 35608708 DOI: 10.1007/s00595-022-02523-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/30/2022] [Indexed: 02/07/2023]
Abstract
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.
Collapse
Affiliation(s)
- Hiraku Kumamaru
- Department of Healthcare Quality Assessment, The University of Tokyo Graduate School of Medicine, 7-3-1 University of Tokyo Hospital Chuoushinryoutou II, 8F, Hongo, Tokyo, 113-8655, Japan.
| | - Yoshihiro Kakeji
- Database Committee, The Japanese Society of Gastroenterological Surgery, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Hiroyuki Yamamoto
- Department of Healthcare Quality Assessment, The University of Tokyo Graduate School of Medicine, 7-3-1 University of Tokyo Hospital Chuoushinryoutou II, 8F, Hongo, Tokyo, 113-8655, Japan
| | - Hideki Hashimoto
- Department of Health and Social Behavior, The University of Tokyo School of Public Health, Tokyo, Japan
| | - Minoru Ono
- Department of Cardiovascular Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Tadashi Iwanaka
- Department of Healthcare Quality Assessment, The University of Tokyo Graduate School of Medicine, 7-3-1 University of Tokyo Hospital Chuoushinryoutou II, 8F, Hongo, Tokyo, 113-8655, Japan
| | - Shigeru Marubashi
- Database Committee, The Japanese Society of Gastroenterological Surgery, Tokyo, Japan
| | - Mitsukazu Gotoh
- The Japanese Society of Gastroenterological Surgery, Tokyo, Japan
| | - Yasuyuki Seto
- The Japanese Society of Gastroenterological Surgery, Tokyo, Japan
| | - Yuko Kitagawa
- The Japanese Society of Gastroenterological Surgery, Tokyo, Japan
| | - Hiroaki Miyata
- Department of Healthcare Quality Assessment, The University of Tokyo Graduate School of Medicine, 7-3-1 University of Tokyo Hospital Chuoushinryoutou II, 8F, Hongo, Tokyo, 113-8655, Japan
| |
Collapse
|
5
|
Kwok K, Tran T, Lew D. Polypectomy for Large Polyps with Endoscopic Mucosal Resection. Gastrointest Endosc Clin N Am 2022; 32:259-276. [PMID: 35361335 DOI: 10.1016/j.giec.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Beginning in 1955, when the saline injection was first described to prevent transmural injury during polyp fulguration, endoscopic mucosal resection (EMR) has grown exponentially, both in scope and in practice. Because EMR is an organ-preserving technique even for large polyps, this allows for comparable outcomes to surgery, but substantially improved cost savings and significantly reduced morbidity and mortality. To achieve this, however, one must master the 4 fundamental components that are critical to the success of EMR- time, team, tools, and technique. This article aims to provide a compendium of state of the art updates within the field of endoluminal resection.
Collapse
Affiliation(s)
- Karl Kwok
- Interventional Endoscopy, Division of Gastroenterology, Kaiser Permanente, Los Angeles Medical Center, 1526 North Edgemont Street, 7th Floor, Los Angeles, CA 90027, USA.
| | - Tri Tran
- Department of Medicine, Kaiser Permanente, Los Angeles Medical Center, 4867 W Sunset Boulevard, Los Angeles, CA 90027, USA
| | - Daniel Lew
- Division of Gastroenterology, Cedars Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048, USA
| |
Collapse
|
6
|
Ludbrook GL. The Hidden Pandemic: the Cost of Postoperative Complications. CURRENT ANESTHESIOLOGY REPORTS 2021; 12:1-9. [PMID: 34744518 PMCID: PMC8558000 DOI: 10.1007/s40140-021-00493-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 12/17/2022]
Abstract
Purpose of Review Population-based increases in ageing and medical co-morbidities are expected to substantially increase the incidence of expensive postoperative complications. This threatens the sustainability of essential surgical care, with negative impacts on patients' health and wellbeing. Recent Findings Identification of key high-risk areas, and implementation of proven cost-effective strategies to manage both outcome and cost across the end-to-end journey of the surgical episode of care, is clearly feasible. However, good programme design and formal cost-effectiveness analysis is critical to identify, and implement, true high value change. Summary Both outcome and cost need to be a high priority for both fundholders and clinicians in perioperative care, with the focus for both groups on delivering high-quality care, which in itself, is the key to good cost management.
Collapse
Affiliation(s)
- Guy L. Ludbrook
- The University of Adelaide, and Royal Adelaide Hospital, C/O Royal Adelaide Hospital, 3G395, 1 Port Road, Adelaide, South Australia 5000 Australia
| |
Collapse
|
7
|
Molina Meneses SP, Palacios Fuenmayor LJ, Castaño LLano RDJ, Mejia Gallego JI, Sánchez Patiño LA. Determinación de los factores predictivos para complicaciones en cirugía electiva de pacientes con cáncer colorrectal. Experiencia del Instituto de Cancerología Las Américas Auna (Colombia, 2016-2019). REVISTA COLOMBIANA DE CIRUGÍA 2021. [DOI: 10.30944/20117582.863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introducción. El pilar fundamental del tratamiento del cáncer colorrectal es la cirugía, situación que expone a los pacientes a la posible presentación de complicaciones, morbimortalidad, pobre calidad de vida, recurrencia tumoral o la muerte. El objetivo de este estudio fue determinar las variables clínicas y quirúrgicas que inciden en el riesgo de la aparición de complicaciones en los pacientes con cáncer colorrectal llevados a cirugía electiva entre los años 2016 y 2019.
Métodos. Estudio observacional, descriptivo, transversal y retrospectivo. Se incluyeron pacientes mayores de 18 años con cáncer colorrectal sometidos a cirugía electiva. Se realizó un análisis multivariado para determinar los factores que se relacionan con las complicaciones postquirúrgicas.
Resultados. Se incluyeron 298 pacientes, 68 % mayores de 60 años, 52,3 % mujeres, 74,2 % presentaban comorbilidades y 48,3 % fueron diagnosticados en estadio III. El 48,3 % presentó complicaciones postoperatorias. De ellos, el 68,1 % no tenía tamización nutricional y el 61,8 % no tenía preparación del colon; un 55 % fueron cirugías del recto, 69,1 % de las cirugías fueron por vía laparoscópica y 71,8 % presentaron sangrado inferior a 500 ml. La mayoría de las complicaciones fueron clasificadas como Clavien-Dindo I-III.
Discusión. Las características de los pacientes fueron similares a los presentados en otros estudios, aunque hubo mayor incidencia de íleo postoperatorio. El análisis multivariado mostró una mayor probabilidad de presentar una complicación en pacientes con diabetes mellitus, hipertensión arterial, falta de tamización nutricional o preparación de colon, cirugía de recto y el sangrado mayor a 500 ml.
Collapse
|
8
|
A Randomized, Multicenter, Open-Label, Blinded End Point, Phase 2, Feasibility, Efficacy, and Safety Trial of Preoperative Microvascular Protection in Patients Undergoing Major Abdominal Surgery. Anesth Analg 2021; 133:1036-1047. [PMID: 34269720 DOI: 10.1213/ane.0000000000005667] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The endothelial glycocalyx, a carbohydrate-rich layer coating all endothelial surfaces, plays a fundamental role in the function of microcirculation. The primary aim of this study was to evaluate the feasibility of using dexamethasone and albumin to protect the endothelial glycocalyx in patients undergoing abdominal surgery. Secondary and exploratory outcomes included efficacy and safety. METHODS We conducted a multicenter, open-label, blinded end point, phase 2, randomized trial. Patients undergoing colorectal, pancreas, or liver surgery were recruited and randomized to receive either intravenous dexamethasone (16 mg) and 20% albumin (100 mL) at induction of anesthesia, then 200 mL of 20% albumin with each subsequent 1000 mL of crystalloid administered (dexamethasone and albumin [Dex-Alb] group), or crystalloid fluid only with no dexamethasone (control group). Feasibility end points included patient recruitment and retention, consent rate, and successful study drug administration. The primary efficacy end point was the measurement of plasma syndecan-1 level on postoperative day (POD) 1, and secondary end points were heparan sulfate levels and inflammatory markers measured at 4 perioperative timepoints. Safety end points included errors in administration of the intervention, hyperglycemia, occurrence of postoperative complications, and patient retention. RESULTS Seventy-two patients were randomized. All feasibility end points were achievable. There were no statistically significant differences observed in median (interquartile range) syndecan-1 levels on POD 1 (39 ng·mL-1 [20-97] in the Dex-Alb group versus 41 ng·mL-1 [19-84] in the control group; difference in medians -2.1, 95% confidence interval [CI], -13 to 8.6; P = .69). The Dex-Alb group had lower POD 1 heparan sulfate levels (319 ng·mL-1 [161-717] in the Dex-Alb group versus 1422 [670-2430] ng·mL-1 in the control group; difference in medians -1085, 95% CI, -1779 to -391) and C-reactive protein (CRP) levels on POD 1 (48 [29-77] mg·L-1 in the Dex-Alb group versus 85 mg·L-1 [49-133] in the control group; difference in medians -48, 95% CI, -75 to -21). Fewer patients had one or more postoperative complication in the Dex-Alb group than in the control group (6 [17%] vs 18 patients [50%]; odds ratio = 0.2, 95% CI, 0.06-0.6). CONCLUSIONS Intravenous dexamethasone and albumin administration was feasible but did not reduce syndecan-1 on POD 1 in patients undergoing abdominal surgery. Given the clinically important CIs observed between the groups for heparan sulfate, CRP, and postoperative complications, a larger trial assessing the associations between dexamethasone and albumin administration and these outcomes is warranted.
Collapse
|
9
|
Abstract
PURPOSE OF REVIEW Episode-based cost measures (EBCM) is a method of combining all services related to a defined episode of care, identified as either a procedure, acute illness or chronic disease, and providing expected cost for that episode or bundle of care. Procedural EBCM has become a major scheme for payment methodology and patient quality of care evaluation. Anesthesiologists need to know how EBCM can impact their clinical practice. RECENT FINDING Centers for Medicare and Medicaid Services (CMS) pays physicians with fee-for-service payment for Clinical Episodes and, in 2020, the EBCM are increasing and currently, represents 4.5% of the total Medicare Part A and B spending [1]. With the recent changes in CMS, it is important, for anesthesia providers to know how cost attribution identifies the cost for all services and complications under anesthetic management. SUMMARY EBCM can impact the anesthesiologist's quality performance, efficiencies measures, and payment. To preserve practice viability, anesthesiologists must understand how their compensation is impacted by services ordered. Anesthesiologists will increasingly be expected to improve quality and efficiencies in EBCM.
Collapse
|
10
|
Postoperative complications and hospital costs following small bowel resection surgery. PLoS One 2020; 15:e0241020. [PMID: 33085700 PMCID: PMC7577438 DOI: 10.1371/journal.pone.0241020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/06/2020] [Indexed: 01/02/2023] Open
Abstract
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] USD 19,659.64 [13,545.81-35,407.14] vs. 11,551.88 [8,849.46-15,329.87], P < 0.001). The development of 1, 2, 3, and ≥ 4 complications increased hospital costs by 11%, 41%, 50%, and 195%, respectively. Similarly, more severe complications incurred higher hospital costs (P < 0.001). After adjustments were made (for the Charlson Comorbidity Index, anemia, surgical urgency and technique, intraoperative fluid administration, blood transfusion, and hospital readmissions), a greater number and increased severity of complications were associated with a higher adjusted median hospital cost. Patients who experienced complications had an adjusted additional median cost of USD 4,187.10 (95% CI: 1,264.89-7,109.31, P = 0.005) compared to those without complications. CONCLUSIONS Postoperative complications are a key target for cost-containment strategies. Our findings demonstrate a high prevalence of postoperative complications following small bowel resection surgery and quantify their associated increase in hospital costs. TRIAL REGISTRATION Australian Clinical Trials Registration number: 12620000322932.
Collapse
|