Evidence map›Paper›PMID 32931872›Full record

ArticleJournal of vascular surgery2021

Quantifying the risk-adjusted hospital costs of postoperative complications after lower extremity bypass in patients with claudication.

Rebecca Sorber, Husain N Alshaikh, Besma Nejim, Christopher J Abularrage, James H Black, Mahmoud B Malas, Caitlin W Hicks

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of vascular surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Rebecca SorberDivision of Vascular Surgery and Endovascular Therapy, Johns Hopkins Medical Institutes, Baltimore, Md.
Husain N AlshaikhThe Johns Hopkins Surgery Center for Outcomes Research, The Johns Hopkins University School of Medicine, Baltimore, Md.
Besma NejimDivision of Vascular Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pa.
Christopher J AbularrageDivision of Vascular Surgery and Endovascular Therapy, Johns Hopkins Medical Institutes, Baltimore, Md.
James H BlackDivision of Vascular Surgery and Endovascular Therapy, Johns Hopkins Medical Institutes, Baltimore, Md.
Mahmoud B MalasDivision of Vascular Surgery, University of San Diego, San Diego, Calif.
Caitlin W HicksDivision of Vascular Surgery and Endovascular Therapy, Johns Hopkins Medical Institutes, Baltimore, Md; The Johns Hopkins Surgery Center for Outcomes Research, The Johns Hopkins University School of Medicine, Baltimore, Md. Electronic address: chicks11@jhmi.edu.
Johns Hopkins University · USPenn State Milton S. Hershey Medical Center · USUniversity of San Diego · US

Funding

Risk Factors and Outcomes Associated with Late-Life Diabetic Peripheral NeuropathyK23DK124515 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI HICKS, CAITLIN WHITNEY · 2020 to 2024
$898k
NIDDK NIH HHS K23 DK124515
6 · The paper itself

Abstract

objectiveIncreasing evidence has shown that the risks associated with surgical revascularization for intermittent claudication outweigh the benefits. The aim of our study was to quantify the cost of care associated with perioperative complications after elective lower extremity bypass (LEB) in patients presenting with intermittent claudication.

methodsAll patients undergoing first-time LEB for claudication in the Healthcare Database (2009-2015) were included. The primary outcome was in-hospital postoperative complications, including major adverse limb events (MALE), major adverse cardiac events (MACE), acute kidney injury, and wound complications. The overall crude hospital costs are reported, and a generalized linear model with log link and inverse Gaussian distribution was used to calculate the predicted hospital costs for specific complications.

resultsOverall, 7154 patients had undergone elective LEB for claudication during the study period. The median age was 66 years (interquartile range, 59-73 years), 67.5% were male, and 75.3% were white. Two thirds of patients (61.2%) had Medicare insurance, followed by private insurance (26.9%), Medicaid (7.7%), and other insurance (4.2%). In-hospital complications occurred in 8.5% of patients, including acute kidney injury in 3.0%, MALE in 2.8%, wound complications in 2.3%, and MACE in 1.0%. The overall median crude hospital cost was $11,783 (interquartile range, $8911-$15,767) per patient. The incremental increase in cost associated with a postoperative complication was significant, ranging from $6183 (95% confidence interval, $4604-$7762) for MALE to $10,485 (95% confidence interval, $6529-$14,441) for MACE after risk adjustment.

conclusionsPostoperative complications after elective LEB for claudication are not uncommon and increase the in-hospital costs by 46% to 78% depending on the complication. Surgical revascularization for claudication should be used sparingly in carefully selected patients.

Indexed as

Hospital CostsAgedAged, 80 and overCost-Benefit AnalysisDatabases, FactualElective Surgical ProceduresFemaleHumansIntermittent ClaudicationLower ExtremityMaleMiddle AgedPeripheral Arterial DiseasePostoperative ComplicationsRetrospective StudiesRisk AssessmentIntermittent claudicationLower extremity bypassPostoperative complicationsPremier Healthcare DatabaseStructured exercise therapy

Identifiers

PMID32931872
PMCPMC7952461
OpenAlexW3086335085

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.