Abstract
ObjectivesTo determine hospital resource utilization, associated costs and the risk of complications during hospitalization for four types of surgical resections and to estimate the incremental burden among patients with cancer compared to those without cancer.MethodsPatients (≥18 years old) were identified from the Premier Research Database of US hospitals if they had any of the following types of elective surgical resections between 1/2008 and 12/2014: lung lobectomy, lower anterior resection of the rectum (LAR), liver wedge resection, or total hysterectomy. Cancer status was determined based on ICD-9-CM diagnosis codes. Operating room time (ORT), length of stay (LOS), and total hospital costs, as well as frequency of bleeding and infections during hospitalization were evaluated. The impact of cancer status on outcomes (from a hospital perspective) was evaluated using multivariable generalized estimating equation models; analyses were conducted separately for each resection type.ResultsAmong the identified patients who underwent surgical resection, 23 858 (87.9% with cancer) underwent lung lobectomy, 13 522 (63.8% with cancer) underwent LAR, 2916 (30.0% with cancer) underwent liver wedge resection and 225 075 (11.3% with cancer) underwent total hysterectomy. After adjusting for patient, procedural, and hospital characteristics, mean ORT, LOS, and hospital cost were statistically higher by 3.2%, 8.2%, and 9.2%, respectively for patients with cancer vs. no cancer who underwent lung lobectomy; statistically higher by 6.9%, 9.4%, and 9.6%, respectively for patients with cancer vs. no cancer who underwent LAR; statistically higher by 4.9%, 14.8%, and 15.7%, respectively for patients with cancer vs. no cancer who underwent liver wedge resection; and statistically higher by 16.0%, 27.4%, and 31.3%, respectively for patients with cancer vs. no cancer who underwent total hysterectomy. Among patients who underwent each type of resection, risks for bleeding and infection were generally higher among patients with cancer as compared to those without cancer.ConclusionsIn this analysis, we found that patients who underwent lung lobectomy, lower anterior resection of the rectum (LAR), liver wedge resection or total hysterectomy for a cancer indication have significantly increased hospital resource utilization compared to these same surgeries for benign indications.
Highlights
Complex surgery and prolonged surgery time during organ resections can impair recovery and short-term outcomes, including extending hospital length of stay [1,2,3]
Patients were identified from the Premier Research Database between January 2008 and December 2014, who had any of the following types of elective surgical resections with open or minimally invasive approaches: lung lobectomy, lower anterior resection (LAR) of the rectum, wedge resection of the liver or total hysterectomy
The risk for infection was significantly greater for patients with cancer vs. patients without cancer. These results are generally consistent with the results found in the overall population undergoing lung lobectomy; the magnitude of Sample Size (N) 225 075
Summary
Complex surgery and prolonged surgery time during organ resections can impair recovery and short-term outcomes, including extending hospital length of stay [1,2,3]. Surgical complexity and preoperative risk factors are associated with greater hospital costs [4, 5]. Among patients who underwent colon, rectal, and pancreatic resections for cancer, greater surgical complexity has been associated with worse outcomes in the 30 days following procedures [3]. Better understanding of the current hospital and economic burden of technically challenging surgical resections may assist with assessing the value of new technologies that may reduce healthcare resource utilization and costs. The objectives of this study were to determine hospital resource utilization, the associated costs, and the frequency of complications during hospitalizations for four common surgical resections and to estimate the incremental burden among patients with cancer undergoing these resections
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
