Infection after surgery for gastrointestinal cancer. Assessing the costs.

Abstract

This study was a retrospective analysis of 85 patients who underwent major abdominal surgery for gastrointestinal malignancies between September 1988 and August 1990. The aim of the study was to evaluate the effects of diagnosed infections, both surgical and nonsurgical, and postoperative fever on the costs and charges for hospitalisation. Patients with preoperative infections or immunosuppression were excluded from the study. 21 (25%) of the patients were diagnosed as having infections and, of those, 13 had major systemic infections and 8 had minor infections (urinary tract or wound infections). Of the 64 noninfected patients, 13 (20%) were febrile. Infection rates were highest in patients with oesophageal, gastric or pancreatic cancer (31, 29 and 24%, respectively). The mean costs for patients with major infections, those with minor infections, febrile patients with no identified infection and afebrile patients with no signs of infection were $US58,067, $US16,726, $US30,236 and $US14,961, respectively. The corresponding charges were $US151,259, $US41,721, $US75,094 and $US37,512, respectively. Major infections and postoperative febrility both significantly increased costs and charges while minor infections only marginally affected these parameters. Comparing patients with and without diagnosed infections, the increases in costs were 402% for microbiological tests ($US497 vs $US99), 144% for other laboratory tests ($US9247 vs $US3790), 167% for radiological examinations ($US3996 vs $US1496), 152% for pharmacy costs ($US2903 vs $US1153), 97% for room costs ($US15,757 vs $US8014), 189% for other items ($US10,151 vs $US3512) and 136% for the total costs ($US42,551 vs $US18,064).(ABSTRACT TRUNCATED AT 250 WORDS)