Evidence map›Paper›PMID 36827411›Full record

ArticlePloS one2023

Postoperative complications and hospital costs following open radical cystectomy: A retrospective study.

Laurence Weinberg, Sarah Aishah Azlina Aitken, Peter Kaldas, Luke Fletcher, Patryck Lloyd-Donald, Peter Le, Daniel Do, Carla Borg Caruana, Dominic Walpole, Joseph Ischia and 3 more

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

Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.9field-weighted citation impact, top 15% 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

5 citing papers in PubMed, 6 citations in OpenAlex.

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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 at 3 institutions in 2 countries.

Laurence WeinbergDepartment of Anesthesia, Austin Health, Heidelberg, Australia.ORCID 0000-0001-7403-7680
Sarah Aishah Azlina AitkenDepartment of Anesthesia, Austin Health, Heidelberg, Australia.
Peter KaldasDepartment of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia.ORCID 0000-0001-6639-8443
Luke FletcherDepartment of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia.
Patryck Lloyd-DonaldDepartment of Anesthesia, Austin Health, Heidelberg, Australia.ORCID 0000-0003-0260-6228
Peter LeDepartment of Anesthesia, Austin Health, Heidelberg, Australia.
Daniel DoDepartment of Anesthesia, Austin Health, Heidelberg, Australia.
Carla Borg CaruanaDepartment of Anesthesia, Austin Health, Heidelberg, Australia.ORCID 0000-0003-4691-9154
Dominic WalpoleDepartment of Anesthesia, Austin Health, Heidelberg, Australia.
Joseph IschiaDepartment of Surgery, The University of Melbourne, Austin Health, Heidelberg, Australia.
Ronald MaBusiness Intelligence Unit, Austin Health, Heidelberg, Australia.
Chong Oon TanDepartment of Anesthesia, Austin Health, Heidelberg, Australia.
Dong-Kyu LeeDepartment of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
Austin Health · AUThe University of Melbourne · AUDongguk University Ilsan Hospital · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate primarily the relationship between postoperative complications and hospital costs, and secondarily the relationship between postoperative complications and mortality, following radical cystectomy.

methodsPostoperative complications were retrospectively examined for 147 patients undergoing radical cystectomy at a university hospital between January 2012 and July 2021. Complications were defined and graded using the Clavien-Dindo classification system. In-hospital cost was calculated using an activity-based costing methodology. Regression modelling was used to investigate the relationships among a priori selected perioperative variables, complications, and costs. The effect of complications on postoperative mortality was ascertained using time-dependent coefficients in a Cox proportional hazards regression model.

results135 (92%) patients experienced one or more postoperative complications. The medians of hospital cost for patients who experienced no complications and those who experienced complications were $42,796.3 (29,222.9-53,532.5) and $81,050.1 (49,614.8-122,533.6) respectively, p < 0.001. Hospital costs were strongly associated with complication severity: Clavien-Dindo grade II complications increased costs by 45.2% (p < 0.001, 95% CI 19.1%-76.6%), and Clavien-Dindo grade III to V complications increased costs by 107.5% (p < 0.001, 95% CI 52.4%-181.8%). Each additional count of complication and increase in Clavien-Dindo complication grade increased the risk of mortality 1.28-fold (RR = 1.28, p = 0.006, 95% CI 1.08-1.53) and 2.50-fold (RR = 2.50, p = 0.012 95% CI 1.23-5.07) respectively.

conclusionsThese findings demonstrate a high prevalence of complications following cystectomy and significant associated increases in hospital costs and mortality. Postoperative complications are a key target for cost-containment strategies.

trial registrationTrial Registration: Australian New Zealand Clinical Trials Registry (ACTRN:12622000057785.

Indexed as

CystectomyUrinary Bladder NeoplasmsAustraliaHospital CostsHumansPostoperative ComplicationsRetrospective Studies

Identifiers

PMID36827411
PMCPMC9956632
OpenAlexW4321766061

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.