Evidence map›Paper›PMID 39181234›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2024

For whom the bell tolls: assessing the incremental costs associated with failure to rescue after elective colorectal surgery.

Kurt S Schultz, Miranda S Moore, Haddon J Pantel, Anne K Mongiu, Vikram B Reddy, Eric B Schneider, Ira L Leeds

Abstract read
In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. Article
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.

Kurt S SchultzDivision of Colon and Rectal Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, United States.
Miranda S MooreDivision of Colon and Rectal Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, United States.
Haddon J PantelDivision of Colon and Rectal Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, United States.
Anne K MongiuDivision of Colon and Rectal Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, United States.
Vikram B ReddyDivision of Colon and Rectal Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, United States.
Eric B SchneiderDivision of Colon and Rectal Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, United States.
Ira L LeedsDivision of Colon and Rectal Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, United States. Electronic address: Ira.Leeds@yale.edu.

Funding

Institutional Career Development CoreKL2TR001862 · NCATS · YALE UNIVERSITY · PI CANTLEY, LLOYD G, EDELMAN, E. JENNIFER · 2016 to 2025
$12.2M
NCATS NIH HHS KL2 TR001862
6 · The paper itself

Abstract

backgroundFailure to rescue after elective surgery is associated with increased healthcare costs. These costs are poorly understood and have not been reported for colorectal surgery. This study aimed to assess the incremental costs of failure to rescue after elective colorectal surgery.

methodsThis was a retrospective study of adult patients identified in the National Inpatient Sample from 2016 to 2019 who underwent an elective colectomy or proctectomy. Patients were stratified into 4 groups: uneventful recovery, successfully rescued, failure to rescue, and died without rescue attempts. "Rescue" was defined as admissions with ≥1 procedure code ≥1 day after the initial procedure. The primary outcome was total admission costs.

resultsOf 451,490 admissions for elective colorectal resection, 94.6% had an uneventful recovery, 4.8% were successfully rescued, 0.4% were failure to rescue, and 0.3% died without rescue attempts. The median total hospital cost for the uneventful recovery cohort was $16,751 (IQR, $12,611-$23,116), for the successfully rescued cohort was $42,295 (IQR, $27,959-$67,077), for the failure-to-rescue cohort was $53,182 (IQR, $30,852-$95,615), and for the died without attempted rescue cohort was $29,296 (IQR, $19,812-$45,919). When comparing cost quantiles by regression analysis, failure-to-rescue patients had significantly higher costs than the successfully rescued patients for the last 3 quantiles (fifth quantile [90th percentile], $163,963 vs $106,521; P < .001).

conclusionAcross a nationally representative cohort, the median total hospital costs for patients who failed to be rescued were $10,887 more than for those who were successfully rescued. These findings emphasize the importance of shared decision making and medical futility and highlight opportunities for resource optimization after postoperative complications.

Indexed as

ColectomyElective Surgical ProceduresFailure to Rescue, Health CareHospital CostsProctectomyAdultAgedFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesUnited StatesColorectal surgeryCost-effectiveness analysisFailure to rescueHealthcare

Identifiers

PMID39181234
PMCPMC13590198

What OpenQuestion holds

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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.