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Title: The hospital costs of complications following colonic resection surgery: A retrospective cohort study.
Austin Authors: Louis, Maleck ;Johnston, Samuel A;Churilov, Leonid ;Ma, Ronald ;Marhoon, Nada ;Burgess, Adele;Christophi, Christopher ;Weinberg, Laurence 
Affiliation: Department of Surgery, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Anaesthesia, Austin Health, 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
The Melbourne Brain Centre, Royal Melbourne Hospital, 300 Grattan St, Parkville, Victoria, 3052, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Issue Date: Jun-2020 2020-04-19
Publication information: Annals of medicine and surgery (2012) 2020; 54: 37-42
Abstract: 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. We 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. Overall 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). There 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.
DOI: 10.1016/j.amsu.2020.03.013
ORCID: 0000-0002-9807-6606
PubMed URL: 32368338
ISSN: 2049-0801
Type: Journal Article
Subjects: Colon surgery
Cost analysis
Postoperative complications
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