Abstract
This study aimed to identify an association between serum calcium (Ca) and phosphate (P) levels, tested during the pre- and postoperative period, with hospital costs and length of hospital stay (LOS) of patients who underwent major abdominal surgery. This retrospective cohort study analyzed the medical records of patients who underwent major abdominal surgery. A total of 3893 patients were included in the analysis, and multivariable linear regression analysis was performed. For a 1 mg/dL increase in preoperative Ca, total hospital costs decreased by 3997.9 dollars (coefficient: −3997.9, 95% confidence interval (CI): −4900.5, −30,953; p-value < 0.01), and for a 1 mg/dL increase in postoperative P, total hospital costs decreased by 702.5 dollars (coefficient: −702.5, 95% CI: −1274.5, −67.3; p-value = 0.03). Furthermore, for a 1 mg/dL increase in preoperative Ca, LOS decreased by 2.9 days (coefficient: −2.9, 95% CI: −3.7, −2.1; p-value < 0.01). For a 1 mg/dL increase in postoperative P, LOS decreased by 3.4 days (coefficient: −3.4, 95% CI: −4.2, −2.6; p-value < 0.01). This study suggested preoperative Ca and postoperative P could be useful indicators for the reduction of hospital costs and decrease in LOS from the perspective of enhanced recovery after surgery.
Highlights
Malnutrition is considered a significant health-related problem that leads to increased mortality, morbidity, and health costs [1]
Considering that Ca and P levels are maintained by the gastrointestinal tract and the kidneys [8], deficiencies of Ca or P could be an indicator of underlying pathologic conditions, such as malnutrition, pancreatitis, sepsis or septic shock, acute kidney injury, or chronic kidney disease [9]
This study included patients who underwent major abdominal surgery, and showed that preoperative Ca was negatively associated with hospital cost and length of stay (LOS), while postoperative P was negatively associated with hospital cost and LOS
Summary
Malnutrition is considered a significant health-related problem that leads to increased mortality, morbidity, and health costs [1]. Considering that Ca and P levels are maintained by the gastrointestinal tract and the kidneys [8], deficiencies of Ca or P could be an indicator of underlying pathologic conditions, such as malnutrition, pancreatitis, sepsis or septic shock, acute kidney injury, or chronic kidney disease [9]. These pathologic conditions often develop in the perioperative period; they can be considered perioperative complications. There has been no study analyzing potential associations between perioperative Ca and P levels and hospital costs or LOS after surgery
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