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Title: The financial burden of complications following rectal resection: A cohort study.
Austin Authors: Johnston, Samuel A;Louis, Maleck ;Churilov, Leonid ;Ma, Ronald ;Marhoon, Nada ;Bui, Andrew ;Christophi, Christopher ;Weinberg, Laurence 
Affiliation: Department of Surgery, University of Melbourne, Parkville, Victoria, Australia
Melbourne Brain Centre, Royal Melbourne Hospital, Parkville..
University of Melbourne, Parkville
Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Finance, Austin Health, Heidelberg, Victoria, Australia
Data Analytics Research and Evaluation (DARE) Centre, Austin Health and The University of Melbourne, Heidelberg, Victoria, Australia
Department of Surgery, Austin Health, Heidelberg, Victoria, Australia
Issue Date: May-2020
Publication information: Medicine 2020; 99(19): e20089
Abstract: To investigate the costs associated with postoperative complications following rectal resection.Rectal resection is a major surgical procedure that carries a significant risk of complications. The occurrence of complications following surgery has both health and financial consequences. There are very few studies that examine the incidence and severity of complications and their financial implications following rectal resection.We identified 381 consecutive patients who underwent a rectal resection within a major university hospital. Patients were included using the International Classification of Diseases (ICD) codes. Complications in the postoperative period were reported using the validated Clavien-Dindo classification system. Both the number and severity of complications were recorded. Activity-based costing methodology was used to report financial outcomes. Preoperative results were also recorded and assessed.A 76.9% [95% CI: 68.3:86.2] of patients experienced one or more complications. Patients who had a complication had a median total cost of $22,567 [IQR 16,607:33,641]. Patients who did not have a complication had a median total cost of $15,882 [IQR 12,971:19,861]. The adjusted additional median cost for patients who had a complication was $5308 [95% CI: 2938:7678] (P < .001). Patients who experienced a complication tended to undergo an open procedure (P = .001), were emergent patients (P = .003), preoperatively had lower albumin levels (36 vs 38, P = .0003) and were anemic (P = .001).Complications following rectal resection are common and are associated with increased costs. Our study highlights the importance of evaluating and preventing complications in the postoperative period.
DOI: 10.1097/MD.0000000000020089
ORCID: 0000-0002-9807-6606
PubMed URL: 32384480
Type: Journal Article
Appears in Collections:Journal articles

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