Abstract
BackgroundColonic resection is a common surgical procedure associated with a high rate of postoperative complications. The aim of this observational study is to estimate the in-hospital costs of complications and to identify perioperative variables associated with complication development following colon resection surgery.Materials and methodsWe conducted a single-centre cohort study with retrospective data collection of 487 patients undergoing colonic resection surgery between 2013 and 2018. Postoperative complications were graded according to the Clavien-Dindo classification system. In-hospital cost of index admission is reported in 2019 United States Dollars. Regression modelling was used to investigate the relationship of a priori selected perioperative variables and presence of complications and costs.ResultsOverall complication prevalence was 69.6% (95%CI:65.5%–73.7%). Median [interquartile range] cost of patients with postoperative complications was significantly increased as compared to patients without complications ($17,963 [13,533:25,178] vs $12,578 [10,196:16,140]; p < 0.0001). Clavien-Dindo Grade I, II, III and IV complications increased costs by 15.8%, 36.8%, 169.4% and 240.1% respectively (p < 0.0001). Presence of complications was significantly associated with Charlson Comorbidity Index (Odds ratio (OR) per 1-unit increase: 1.09; 95%CI:1.02 to 1.17), preoperative albumin levels (OR per 1-unit increase: 0.94; 95%CI:0.90 to 0.98) and open as compared to laparoscopic resection (OR: 2.41; 95%CI:1.32 to 4.42).ConclusionsThere is a high prevalence of complications following colonic resection surgery. Postoperative complications, including minor complications (Clavien-Dindo Grade I-II), were associated with a significant increase in hospital costs and are a key target for cost containment strategies.
Highlights
Colonic resection is a common surgical procedure associated with a high rate of postoperative complications
Given that colon resection surgery is a common procedure with a high rate of postoperative adverse events relative to other major surgeries [5], it is expected to be a major contributor to hospital costs
Annals of Medicine and Surgery 54 (2020) 37–42 literature, we provide an in-depth analysis of the associations between patient factors, complications and costs following colon resection surgery
Summary
Colonic resection is a common surgical procedure associated with a high rate of postoperative complications. The aim of this observational study is to estimate the in-hospital costs of complications and to identify perioperative variables associated with complication development following colon resection surgery. Postoperative complications, including minor complications (Clavien-Dindo Grade I-II), were associated with a significant increase in hospital costs and are a key target for cost containment strategies. There are few high-quality costing studies exploring the financial burden of complications following colon resection surgery To address this important gap in the Annals of Medicine and Surgery 54 (2020) 37–42 literature, we provide an in-depth analysis of the associations between patient factors, complications and costs following colon resection surgery. This will allow clinicians and hospital administrators to make more informed decisions about the breakdown of costs and reflect on local factors that might affect a hospital's cost of delivering care
Sign-in/Register to view highlights & summary 
Published Version (
Free)
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 call