Risk factors and economic burden of postoperative anastomotic leakage related events in patients who underwent surgeries for colorectal cancer.
<h4>Background</h4>Nationwide research about the clinical and economic burden caused by anastomotic leakage (AL) has not been published yet in Korea. This study assessed the AL rate and quantified the economic burden using the nationwide database.<h4>Methods</h4>This real wor...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0267950 |
| _version_ | 1811239223802462208 |
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| author | Jeonghyun Kang Hyesung Kim HyeJin Park Bora Lee Kang Young Lee |
| author_facet | Jeonghyun Kang Hyesung Kim HyeJin Park Bora Lee Kang Young Lee |
| author_sort | Jeonghyun Kang |
| collection | DOAJ |
| description | <h4>Background</h4>Nationwide research about the clinical and economic burden caused by anastomotic leakage (AL) has not been published yet in Korea. This study assessed the AL rate and quantified the economic burden using the nationwide database.<h4>Methods</h4>This real world evidence study used health claims data provided by the Korean Health Insurance Review and Assessment Service (HIRA, which showed that 156,545 patients underwent anterior resection (AR), low anterior resection (LAR), or ultra-low anterior resection (uLAR) for colorectal cancer (CRC) between January 1, 2007 and January 31, 2020. The incidence of AL was identified using a composite operational definition, a composite of imaging study, antibacterial drug use, reoperation, or image-guided percutaneous drainage. Total hospital costs and length of stay (LOS) were evaluated in patients with AL versus those without AL during index hospitalization and within 30 days after the surgery.<h4>Results</h4>Among 120,245 patients who met the eligibility criteria, 7,194 (5.98%) patients had AL within 30 days after surgery. Male gender, comorbidities (diabetes, metastatic disease, ischemic heart disease, ischemic stroke), protective ostomy, and multiple linear stapler use, blood transfusion, and urinary tract injury were associated with the higher odds of AL. Older age, rectosigmoid junction cancer, AR, LAR, and laparoscopic approach were related with the reduced odds of AL. Patients with AL incurred higher costs for index hospitalization compared to those without AL (8,991 vs. 7,153 USD; p<0.0001). Patients with AL also required longer LOS (16.78 vs. 14.22 days; p<0.0001) and readmissions (20.83 vs. 13.93 days; p<0.0001).<h4>Conclusion</h4>Among patients requiring resection for CRC, the occurrence of AL was associated with significantly increased costs and LOS. Preventing AL could not only produce superior clinical outcomes, but also reduce the economic burden for patients and payers. |
| first_indexed | 2024-04-12T12:56:12Z |
| format | Article |
| id | doaj.art-981796f9edf7499d8fbbcc29f69e836a |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-12T12:56:12Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-981796f9edf7499d8fbbcc29f69e836a2022-12-22T03:32:19ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01175e026795010.1371/journal.pone.0267950Risk factors and economic burden of postoperative anastomotic leakage related events in patients who underwent surgeries for colorectal cancer.Jeonghyun KangHyesung KimHyeJin ParkBora LeeKang Young Lee<h4>Background</h4>Nationwide research about the clinical and economic burden caused by anastomotic leakage (AL) has not been published yet in Korea. This study assessed the AL rate and quantified the economic burden using the nationwide database.<h4>Methods</h4>This real world evidence study used health claims data provided by the Korean Health Insurance Review and Assessment Service (HIRA, which showed that 156,545 patients underwent anterior resection (AR), low anterior resection (LAR), or ultra-low anterior resection (uLAR) for colorectal cancer (CRC) between January 1, 2007 and January 31, 2020. The incidence of AL was identified using a composite operational definition, a composite of imaging study, antibacterial drug use, reoperation, or image-guided percutaneous drainage. Total hospital costs and length of stay (LOS) were evaluated in patients with AL versus those without AL during index hospitalization and within 30 days after the surgery.<h4>Results</h4>Among 120,245 patients who met the eligibility criteria, 7,194 (5.98%) patients had AL within 30 days after surgery. Male gender, comorbidities (diabetes, metastatic disease, ischemic heart disease, ischemic stroke), protective ostomy, and multiple linear stapler use, blood transfusion, and urinary tract injury were associated with the higher odds of AL. Older age, rectosigmoid junction cancer, AR, LAR, and laparoscopic approach were related with the reduced odds of AL. Patients with AL incurred higher costs for index hospitalization compared to those without AL (8,991 vs. 7,153 USD; p<0.0001). Patients with AL also required longer LOS (16.78 vs. 14.22 days; p<0.0001) and readmissions (20.83 vs. 13.93 days; p<0.0001).<h4>Conclusion</h4>Among patients requiring resection for CRC, the occurrence of AL was associated with significantly increased costs and LOS. Preventing AL could not only produce superior clinical outcomes, but also reduce the economic burden for patients and payers.https://doi.org/10.1371/journal.pone.0267950 |
| spellingShingle | Jeonghyun Kang Hyesung Kim HyeJin Park Bora Lee Kang Young Lee Risk factors and economic burden of postoperative anastomotic leakage related events in patients who underwent surgeries for colorectal cancer. PLoS ONE |
| title | Risk factors and economic burden of postoperative anastomotic leakage related events in patients who underwent surgeries for colorectal cancer. |
| title_full | Risk factors and economic burden of postoperative anastomotic leakage related events in patients who underwent surgeries for colorectal cancer. |
| title_fullStr | Risk factors and economic burden of postoperative anastomotic leakage related events in patients who underwent surgeries for colorectal cancer. |
| title_full_unstemmed | Risk factors and economic burden of postoperative anastomotic leakage related events in patients who underwent surgeries for colorectal cancer. |
| title_short | Risk factors and economic burden of postoperative anastomotic leakage related events in patients who underwent surgeries for colorectal cancer. |
| title_sort | risk factors and economic burden of postoperative anastomotic leakage related events in patients who underwent surgeries for colorectal cancer |
| url | https://doi.org/10.1371/journal.pone.0267950 |
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