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HOLLYWOOD, FLA. — Postoperative costs for patients who develop an ileus after colectomy are almost double those for patients without this complication, a retrospective study indicates.
“It's already established that a postoperative ileus increases length of stay, but the economic impact has been hard to quantify,” Dr. Theodor Asgeirsson said at the annual meeting of the American Society of Colon and Rectal Surgeons.
In a review of 191 colectomies performed at the Ferguson Clinic in Grand Rapids, Mich., starting in July 2007, Dr. Asgeirsson and his colleagues found that postoperative ileus incidence was 26%, including 41 primary cases and 10 secondary cases. A primary postoperative ileus was defined as three episodes of emesis in 24 hours and/or insertion of a nasogastric tube during the index admission. A secondary ileus was associated with intra-abdominal complications. Nineteen patients in the primary ileus group and one in the secondary group required a nasogastric tube.
Development of an ileus affected slightly more than one-quarter of patients, and was associated with 39% of total care costs in the study, said Dr. Asgeirsson, a researcher at the clinic.
During index admissions, the total cost for patients with a postoperative ileus was $31,629 vs. $17,626 for those without this complication, a statistically significant difference. “Surprisingly, this was not significantly different for secondary postoperative ileus,” Dr. Asgeirsson said.
The total readmission cost for postoperative ileus patients was $8,742 vs. $12,946 for non-ileus patients. Readmission for gastrointestinal failure, including nausea, vomiting, and/or poor oral intake, was also considered ileus, unless small bowel obstruction was identified. In contrast, non-ileus patients were readmitted for more serious adverse events, he said.
When asked whether total costs were higher only because patients with a postoperative ileus had longer stays, Dr. Asgeirsson said no. “When these patients get readmitted for a delayed postop ileus, the team usually wants to rule out the worst, such as anastomosis,” he said. “We are doing a lot of diagnostic tests that increase costs.”
HOLLYWOOD, FLA. — Postoperative costs for patients who develop an ileus after colectomy are almost double those for patients without this complication, a retrospective study indicates.
“It's already established that a postoperative ileus increases length of stay, but the economic impact has been hard to quantify,” Dr. Theodor Asgeirsson said at the annual meeting of the American Society of Colon and Rectal Surgeons.
In a review of 191 colectomies performed at the Ferguson Clinic in Grand Rapids, Mich., starting in July 2007, Dr. Asgeirsson and his colleagues found that postoperative ileus incidence was 26%, including 41 primary cases and 10 secondary cases. A primary postoperative ileus was defined as three episodes of emesis in 24 hours and/or insertion of a nasogastric tube during the index admission. A secondary ileus was associated with intra-abdominal complications. Nineteen patients in the primary ileus group and one in the secondary group required a nasogastric tube.
Development of an ileus affected slightly more than one-quarter of patients, and was associated with 39% of total care costs in the study, said Dr. Asgeirsson, a researcher at the clinic.
During index admissions, the total cost for patients with a postoperative ileus was $31,629 vs. $17,626 for those without this complication, a statistically significant difference. “Surprisingly, this was not significantly different for secondary postoperative ileus,” Dr. Asgeirsson said.
The total readmission cost for postoperative ileus patients was $8,742 vs. $12,946 for non-ileus patients. Readmission for gastrointestinal failure, including nausea, vomiting, and/or poor oral intake, was also considered ileus, unless small bowel obstruction was identified. In contrast, non-ileus patients were readmitted for more serious adverse events, he said.
When asked whether total costs were higher only because patients with a postoperative ileus had longer stays, Dr. Asgeirsson said no. “When these patients get readmitted for a delayed postop ileus, the team usually wants to rule out the worst, such as anastomosis,” he said. “We are doing a lot of diagnostic tests that increase costs.”
HOLLYWOOD, FLA. — Postoperative costs for patients who develop an ileus after colectomy are almost double those for patients without this complication, a retrospective study indicates.
“It's already established that a postoperative ileus increases length of stay, but the economic impact has been hard to quantify,” Dr. Theodor Asgeirsson said at the annual meeting of the American Society of Colon and Rectal Surgeons.
In a review of 191 colectomies performed at the Ferguson Clinic in Grand Rapids, Mich., starting in July 2007, Dr. Asgeirsson and his colleagues found that postoperative ileus incidence was 26%, including 41 primary cases and 10 secondary cases. A primary postoperative ileus was defined as three episodes of emesis in 24 hours and/or insertion of a nasogastric tube during the index admission. A secondary ileus was associated with intra-abdominal complications. Nineteen patients in the primary ileus group and one in the secondary group required a nasogastric tube.
Development of an ileus affected slightly more than one-quarter of patients, and was associated with 39% of total care costs in the study, said Dr. Asgeirsson, a researcher at the clinic.
During index admissions, the total cost for patients with a postoperative ileus was $31,629 vs. $17,626 for those without this complication, a statistically significant difference. “Surprisingly, this was not significantly different for secondary postoperative ileus,” Dr. Asgeirsson said.
The total readmission cost for postoperative ileus patients was $8,742 vs. $12,946 for non-ileus patients. Readmission for gastrointestinal failure, including nausea, vomiting, and/or poor oral intake, was also considered ileus, unless small bowel obstruction was identified. In contrast, non-ileus patients were readmitted for more serious adverse events, he said.
When asked whether total costs were higher only because patients with a postoperative ileus had longer stays, Dr. Asgeirsson said no. “When these patients get readmitted for a delayed postop ileus, the team usually wants to rule out the worst, such as anastomosis,” he said. “We are doing a lot of diagnostic tests that increase costs.”