Luke Traeger, Sergei Bedrikovetski, Rowan V. David, Alice A. Jay, James W. Moore, Tarik Sammour
{"title":"大肠癌手术中肌肉疏松症的财务影响:澳大利亚一家公立医院的成本分析","authors":"Luke Traeger, Sergei Bedrikovetski, Rowan V. David, Alice A. Jay, James W. Moore, Tarik Sammour","doi":"10.1111/ans.19230","DOIUrl":null,"url":null,"abstract":"IntroductionSarcopenia has a detrimental impact on patient outcomes following colorectal surgery, increasing financial strain on the healthcare system. Given the absence of specific Australian data, this study aimed to measure the cost of sarcopenia in the context of colorectal surgery in an Australian public hospital.MethodsA retrospective cost analysis, following CHEERS guidelines, was conducted on major elective colorectal cancer surgical cases at the Royal Adelaide Hospital between 2018 and 2022. The cross‐sectional psoas area was measured through computed tomography (CT) imaging at the level of the third lumbar vertebrae, and sarcopenia was determined using gender‐specific thresholds. Hospital billing data was used to gather costings (AU$).ResultsOut of 271 patients, 57 (21.0%) comprised the sarcopenic group (SG). SG patients were older (74 vs. 69 years, <jats:italic>P</jats:italic> < 0.001), had a higher American Society of Anaesthesiologists (>II, 71.9% vs. 53.7%, <jats:italic>P</jats:italic> = 0.014) and a lower median body mass index (24.8 vs. 28.7 kg/m<jats:sup>2</jats:sup>, <jats:italic>P</jats:italic> < 0.001). The SG exhibited a greater likelihood of complications (84.2 vs. 68.7%, <jats:italic>P</jats:italic> = 0.020) and prolonged hospital stay by 1 day (median 7 vs. 6 days, <jats:italic>P</jats:italic> = 0.027). Despite an increased mean total cost of hospital admission, no statistically significant difference was found (AU$37 712 vs. $34 845, <jats:italic>P</jats:italic> = 0.296). Multivariate analysis revealed hypoalbuminemia, prolonged operative time, postoperative ileus, return to theatre, Clavien‐Dindo grade ≥3 complications, and prolonged stay increased overall cost (<jats:italic>P</jats:italic> < 0.05).ConclusionSarcopenia was not associated with a significantly increased cost of colorectal surgery in our institution. Future studies examining the cost‐effectiveness of prehabilitation programmes targeting sarcopenia should be considered.","PeriodicalId":8158,"journal":{"name":"ANZ Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Financial implications of sarcopenia in colorectal cancer surgery: a cost analysis in an Australian public hospital\",\"authors\":\"Luke Traeger, Sergei Bedrikovetski, Rowan V. David, Alice A. Jay, James W. Moore, Tarik Sammour\",\"doi\":\"10.1111/ans.19230\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"IntroductionSarcopenia has a detrimental impact on patient outcomes following colorectal surgery, increasing financial strain on the healthcare system. Given the absence of specific Australian data, this study aimed to measure the cost of sarcopenia in the context of colorectal surgery in an Australian public hospital.MethodsA retrospective cost analysis, following CHEERS guidelines, was conducted on major elective colorectal cancer surgical cases at the Royal Adelaide Hospital between 2018 and 2022. The cross‐sectional psoas area was measured through computed tomography (CT) imaging at the level of the third lumbar vertebrae, and sarcopenia was determined using gender‐specific thresholds. Hospital billing data was used to gather costings (AU$).ResultsOut of 271 patients, 57 (21.0%) comprised the sarcopenic group (SG). SG patients were older (74 vs. 69 years, <jats:italic>P</jats:italic> < 0.001), had a higher American Society of Anaesthesiologists (>II, 71.9% vs. 53.7%, <jats:italic>P</jats:italic> = 0.014) and a lower median body mass index (24.8 vs. 28.7 kg/m<jats:sup>2</jats:sup>, <jats:italic>P</jats:italic> < 0.001). The SG exhibited a greater likelihood of complications (84.2 vs. 68.7%, <jats:italic>P</jats:italic> = 0.020) and prolonged hospital stay by 1 day (median 7 vs. 6 days, <jats:italic>P</jats:italic> = 0.027). Despite an increased mean total cost of hospital admission, no statistically significant difference was found (AU$37 712 vs. $34 845, <jats:italic>P</jats:italic> = 0.296). Multivariate analysis revealed hypoalbuminemia, prolonged operative time, postoperative ileus, return to theatre, Clavien‐Dindo grade ≥3 complications, and prolonged stay increased overall cost (<jats:italic>P</jats:italic> < 0.05).ConclusionSarcopenia was not associated with a significantly increased cost of colorectal surgery in our institution. Future studies examining the cost‐effectiveness of prehabilitation programmes targeting sarcopenia should be considered.\",\"PeriodicalId\":8158,\"journal\":{\"name\":\"ANZ Journal of Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ANZ Journal of Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/ans.19230\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ANZ Journal of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/ans.19230","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Financial implications of sarcopenia in colorectal cancer surgery: a cost analysis in an Australian public hospital
IntroductionSarcopenia has a detrimental impact on patient outcomes following colorectal surgery, increasing financial strain on the healthcare system. Given the absence of specific Australian data, this study aimed to measure the cost of sarcopenia in the context of colorectal surgery in an Australian public hospital.MethodsA retrospective cost analysis, following CHEERS guidelines, was conducted on major elective colorectal cancer surgical cases at the Royal Adelaide Hospital between 2018 and 2022. The cross‐sectional psoas area was measured through computed tomography (CT) imaging at the level of the third lumbar vertebrae, and sarcopenia was determined using gender‐specific thresholds. Hospital billing data was used to gather costings (AU$).ResultsOut of 271 patients, 57 (21.0%) comprised the sarcopenic group (SG). SG patients were older (74 vs. 69 years, P < 0.001), had a higher American Society of Anaesthesiologists (>II, 71.9% vs. 53.7%, P = 0.014) and a lower median body mass index (24.8 vs. 28.7 kg/m2, P < 0.001). The SG exhibited a greater likelihood of complications (84.2 vs. 68.7%, P = 0.020) and prolonged hospital stay by 1 day (median 7 vs. 6 days, P = 0.027). Despite an increased mean total cost of hospital admission, no statistically significant difference was found (AU$37 712 vs. $34 845, P = 0.296). Multivariate analysis revealed hypoalbuminemia, prolonged operative time, postoperative ileus, return to theatre, Clavien‐Dindo grade ≥3 complications, and prolonged stay increased overall cost (P < 0.05).ConclusionSarcopenia was not associated with a significantly increased cost of colorectal surgery in our institution. Future studies examining the cost‐effectiveness of prehabilitation programmes targeting sarcopenia should be considered.
期刊介绍:
ANZ Journal of Surgery is published by Wiley on behalf of the Royal Australasian College of Surgeons to provide a medium for the publication of peer-reviewed original contributions related to clinical practice and/or research in all fields of surgery and related disciplines. It also provides a programme of continuing education for surgeons. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.