Evidence map›Paper›PMID 35608708›Full record

ArticleSurgery today2022

Cost of postoperative complications of lower anterior resection for rectal cancer: a nationwide registry study of 15,187 patients.

Hiraku Kumamaru, Yoshihiro Kakeji, Kiyohide Fushimi, Koichi Benjamin Ishikawa, Hiroyuki Yamamoto, Hideki Hashimoto, Minoru Ono, Tadashi Iwanaka, Shigeru Marubashi, Mitsukazu Gotoh and 3 more

Abstract read
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In one paragraph

Article in Surgery today, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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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

13 authors.

Hiraku KumamaruDepartment of Healthcare Quality Assessment, The University of Tokyo Graduate School of Medicine, 7-3-1 University of Tokyo Hospital Chuoushinryoutou II, 8F, Hongo, Tokyo, 113-8655, Japan. hik205@mail.harvard.edu.ORCID http://orcid.org/0000-0002-9759-6191
Yoshihiro KakejiDatabase Committee, The Japanese Society of Gastroenterological Surgery, Tokyo, Japan.
Kiyohide FushimiDepartment of Health Policy and Informatics, Tokyo Medical and Dental University, Tokyo, Japan.
Koichi Benjamin IshikawaInternational University of Health and Welfare, Tokyo, Japan.
Hiroyuki YamamotoDepartment of Healthcare Quality Assessment, The University of Tokyo Graduate School of Medicine, 7-3-1 University of Tokyo Hospital Chuoushinryoutou II, 8F, Hongo, Tokyo, 113-8655, Japan.
Hideki HashimotoDepartment of Health and Social Behavior, The University of Tokyo School of Public Health, Tokyo, Japan.
Minoru OnoDepartment of Cardiovascular Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Tadashi IwanakaDepartment of Healthcare Quality Assessment, The University of Tokyo Graduate School of Medicine, 7-3-1 University of Tokyo Hospital Chuoushinryoutou II, 8F, Hongo, Tokyo, 113-8655, Japan.
Shigeru MarubashiDatabase Committee, The Japanese Society of Gastroenterological Surgery, Tokyo, Japan.
Mitsukazu GotohThe Japanese Society of Gastroenterological Surgery, Tokyo, Japan.
Yasuyuki SetoThe Japanese Society of Gastroenterological Surgery, Tokyo, Japan.
Yuko KitagawaThe Japanese Society of Gastroenterological Surgery, Tokyo, Japan.
Hiroaki MiyataDepartment of Healthcare Quality Assessment, The University of Tokyo Graduate School of Medicine, 7-3-1 University of Tokyo Hospital Chuoushinryoutou II, 8F, Hongo, Tokyo, 113-8655, Japan.

Funding

Japan Agency for Medical Research and Development 16lk1010004h0002
6 · The paper itself

Abstract

purposeTo assess the increase in hospital costs associated with postoperative complications after lower anterior resection (LAR) for rectal cancer.

methodsThe subjects of this retrospective analysis were patients who underwent elective LAR surgery between April, 2015 and March, 2017, collected from a Japanese nationwide gastroenterological surgery registry linked to hospital-based claims data. We evaluated total and category-specific hospitalization costs based on the level of postoperative complications categorized using the Clavien-Dindo (CD) classification. We assessed the relative increase in hospital costs, adjusting for preoperative factors and hospital case volume.

resultsWe identified 15,187 patients (mean age 66.8) treated at 884 hospitals. Overall, 71.8% had no recorded complications, whereas 7.6%, 10.8%, 9.0%, 0.6%, and 0.2% had postoperative complications of CD grades I-V, respectively. The median (25th-75th percentiles) hospital costs were $17.3 K (16.1-19.3) for the no-complications group, and $19.1 K (17.3-22.2), $21.0 K (18.5-25.0), $27.4 K (22.4-33.9), $41.8 K (291-618), and $22.7 K (183-421) for the CD grades I-V complication groups, respectively. The multivariable model identified that complications of CD grades I-V were associated with 11%, 21%, 61%, 142%, and 70% increases in in-hospital costs compared with no complications.

conclusionsPostoperative complications and their severity are strongly associated with increased hospital costs and health-care resource utilization. Implementing strategies to prevent postoperative complications will improve patients' clinical outcomes and reduce hospital care costs substantially.

Indexed as

Rectal NeoplasmsAgedHospital CostsHumansPostoperative ComplicationsRegistriesRetrospective StudiesClavien–Dindo classificationCostLower anterior resectionPostoperative complications

Identifiers

PMID35608708
PMCPMC9700610

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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.