Ann Surg Treat Res.  2016 Jan;90(1):21-28. 10.4174/astr.2016.90.1.21.

Impact of postoperative complications on clinical and economic consequences in pancreatic surgery

• Cecka F
• Jon B
• Cermakova
• Subrt Z
• Ferko A

• KMID: 2149928
• DOI: http://doi.org/10.4174/astr.2016.90.1.21

Abstract

PURPOSE
Patients who develop complications consume a disproportionately large share of available resources in surgery; therefore the attention of healthcare funders focuses on the economic impact of complications. The main objective of this work was to assess the clinical and economic impact of postoperative complications in pancreatic surgery, and furthermore to assess risk factors for increased costs.
METHODS
In all, 161 consecutive patients underwent pancreatic resection. The costs of the treatment were determined and analyzed.
RESULTS
The overall morbidity rate was 53.4%, and the in-hospital mortality rate was 3.7%. The median of costs for all patients without complication was 3,963 Euro, whereas the median of costs for patients with at least one complication was significantly increased at 10,670 Euro (P < 0.001). In multivariate analysis American Society of Anesthesiologists > or = 3 (P = 0.006), multivisceral resection (P < 0.001) and any complication (P < 0.001) were independently associated with increased costs.
CONCLUSION
Postoperative complications are associated with an increase in mortality, length of hospital stay, and hospital costs. The treatment costs increase with the severity of the postoperative complications. Those factors that are known to increase the treatment costs in pancreatic resection should be considered when planning patients for surgery.

Keyword

Pancreaticoduodenectomy; Pancreatectomy; Postoperative complications; Pancreatic fistula

MeSH Terms

Delivery of Health Care
Health Care Costs
Hospital Costs
Hospital Mortality
Humans
Length of Stay
Mortality
Multivariate Analysis
Pancreatectomy
Pancreatic Fistula
Pancreaticoduodenectomy
Postoperative Complications*
Risk Factors

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