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Gani, F; Buettner, S; Margonis, GA; Sasaki, K; Wagner, D; Kim, Y; Hundt, J; Kamel, IR; Pawlik, TM.
Sarcopenia predicts costs among patients undergoing major abdominal operations.
Surgery. 2016; 160(5):1162-1171
Doi: 10.1016/j.surg.2016.05.002
Web of Science
PubMed
FullText
FullText_MUG
- Co-Autor*innen der Med Uni Graz
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Wagner Doris
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- Abstract:
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Although sarcopenia has been identified as a predictor of poor, postoperative, clinical outcomes, the financial impact of sarcopenia remains undetermined. We sought to evaluate the relationship between sarcopenia and hospital finances among a cohort of patients undergoing a hepato-pancreatico-biliary or colorectal resection.
Clinical, financial, and morphometric data were collected for 1,169 patients undergoing operative resection between January 2011 and December 2013 at the Johns Hopkins Hospital. Multivariable regression analysis was performed to assess the relationship between sarcopenia and total hospital costs.
Using sex-specific cutoffs for total psoas volume, 293 patients were categorized as sarcopenic. The presence of sarcopenia was associated with a $14,322 increase in the total hospital cost (median covariate-adjusted cost, sarcopenia versus no sarcopenia: $38,804 vs $24,482, P < .001). Patients who presented with sarcopenia demonstrated a higher total hospital cost within the subgroup of patients who developed a postoperative complication (sarcopenia versus no sarcopenia: $65,856 vs $59,609) and among those patients who did not develop a postoperative complication (sarcopenia versus no sarcopenia: $26,282 vs $23,763, both P < .001). Similarly, total hospital costs were higher among patients presenting with sarcopenia regardless of the length of stay for index admission (observed:expected, length of stay < 1: sarcopenia versus no sarcopenia: $25,038 vs $22,827; observed:expected, length of stay > 1: sarcopenia versus no sarcopenia: $43,283 vs $38,679, both P < .001).
As measured by sarcopenia, patient frailty is inversely related to total hospital costs. Sarcopenia represents a novel tool for forecasting patient outcomes and operative costs and can be used to inform quality improvement and cost containment strategies.
Copyright © 2016 Elsevier Inc. All rights reserved.
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Aged -
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Cohort Studies -
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Databases, Factual -
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Digestive System Surgical Procedures - adverse effects
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Digestive System Surgical Procedures - economics
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Digestive System Surgical Procedures - methods
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Female -
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Hospital Costs - trends
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Humans -
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Length of Stay - economics
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Male -
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Middle Aged -
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Postoperative Complications - economics
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Postoperative Complications - physiopathology
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Predictive Value of Tests -
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Reference Values -
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Retrospective Studies -
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Sarcopenia - economics
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Sarcopenia - surgery