ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2018
The Cost of Complications Following Major Resection of Malignant Neoplasia.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Index hospital cost of adverse events following thoracic surgery: a systematic review of economic literature.BMJ open · 2023Pooled it
- Financial burden of postoperative complications following colonic resection: A systematic review.Medicine · 2021Pooled it
- The feasibility of implementing and evaluating individualised digital prehabilitation prior to major elective surgery in adults aged ≥ 50 years: the PreActiv intervention.Perioperative medicine (London, England) · 2026Article
- Robotic versus open pancreaticoduodenectomy in octogenarians: a comparative propensity score analysis of perioperative outcomes.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2025Article
- Cost-utility advantage of interventional endoscopy.Surgical endoscopy · 2023Article
- COST-EFFECTIVENESS OF THE USE OF ACERTO PROTOCOL IN MAJOR DIGESTIVE SURGERY.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2022Article
- Multidisciplinary management of elderly patients with rectal cancer: recommendations from the SICG (Italian Society of Geriatric Surgery), SIFIPAC (Italian Society of Surgical Pathophysiology), SICE (Italian Society of Endoscopic Surgery and new technologies), and the WSES (World Society of Emergency Surgery) International Consensus Project.World journal of emergency surgery : WJES · 2021Article
- Quality Versus Costs Related to Gastrointestinal Surgery: Disentangling the Value Proposition.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Review
- Observational
- Risk reduction in kidney surgery.Annals of translational medicine · 2019Article
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Authors and funding
9 authors.
Funding
Abstract
backgroundRising healthcare costs have led to increased focus on the need to achieve a higher "value of care." As value-maximization efforts expand to include more complex surgical patients, evidence to support meaningful implementation of complication-based initiatives is lacking. The objective of this study was to compare incremental costs of complications following major gastrointestinal (GI) resections for organ-specific malignant neoplasia using nationally representative data.
methodsNational (Nationwide) Inpatient Sample data, 2001-2014, were queried for adult (≥ 18 years) patients undergoing major resections for malignant neoplasia. Based on system-based complications considered relevant to the long-term treatment of GI disease, stratified differences in risk-adjusted incremental hospital costs and complication probabilities were compared. Differences in surgical outcomes and costs over time were also assessed.
resultsA total of 293,967 patients were included, weighted to represent 1,408,117 patients nationwide. One fourth (26.1%; 95% CI, 25.7-26.4%) experienced ≥ 1 pre-discharge complication (range, 45.3% esophagectomy to 24.0% rectal resection). Resultant annual risk-adjusted incremental hospital costs totaled $540 million nationwide (19.5% of the overall cost of care and an average of $20,900 per patient). Costs varied substantially with both cancer/resection type and complication group, ranging from $76.7 million for colectomies with infectious complications to $0.2 million for rectal resections with urinary complications. For each resection type, infectious ($154.7 million), GI ($85.5 million), and pulmonary ($77.9 million) complications were among the most significant drivers of increased hospital cost.
conclusionsQuantifying and comparing the impact of complications on an indication-specific level in more complex patients offers an important step toward allowing providers/payers to meaningfully prioritize the design of novel and adaptation of existing value-maximization approaches.
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