Health-related quality of life and hospital costs following esophageal resection: a prospective cohort study.
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ABSTRACT: Background
The incidence rates for adenocarcinoma of the esophagus are increasing while the prognosis has only improved slightly. There is no apparent benefit in short- and long-term survival after different surgical strategies, but surgery is associated with significant morbidity. The goal of this study is to prospectively assess the quality of life and hospital costs after esophageal resections depending on the development of complications.Methods
Prospective data was collected from 47 patients undergoing an esophageal resection for esophageal cancer participating in the prospective LAParotomy or LAParoscopy and Adhesions (LAPAD) study (clinicaltrials.gov registration number: NCT01236625). A comparison was made between patients who developed major complications and minor or no complications regarding quality of life and hospital costs.Results
Thirteen patients developed major complications while 34 patients developed only minor or no complications. Patients with major complications had a mean hospital cost of $16,369 vs $12,409 for patients without or with minor complications. We found no difference in quality of life between the two groups 6 months after surgery.Conclusions
In our cohort, major complications did not seem to have a detrimental effect on postoperative quality of life 6 months after surgery but they increased costs associated with esophageal resection.
SUBMITTER: Strik C
PROVIDER: S-EPMC4558724 | biostudies-literature | 2015 Sep
REPOSITORIES: biostudies-literature
Publications
Health-related quality of life and hospital costs following esophageal resection: a prospective cohort study.
Strik C C ten Broek R P RP van der Kolk M M van Goor H H Bonenkamp J J JJ
World journal of surgical oncology 20150904
<h4>Background</h4>The incidence rates for adenocarcinoma of the esophagus are increasing while the prognosis has only improved slightly. There is no apparent benefit in short- and long-term survival after different surgical strategies, but surgery is associated with significant morbidity. The goal of this study is to prospectively assess the quality of life and hospital costs after esophageal resections depending on the development of complications.<h4>Methods</h4>Prospective data was collected ...[more]
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Project description:Interventions: Elective or emergent colonic resection, defined using the procedural ICD-10 codes:
32000-00 Limited excision of large intestine with formation of stoma
32000-01 Right hemicolectomy with formation of stoma
32000-02 Laparoscopic limited excision of large intestine with formation of stoma
32000-03 Laparoscopic right hemicolectomy with formation of stoma
32003-00 Limited excision of large intestine with anastomosis
32003-01 Right hemicolectomy with anastomosis
32003-02 Laparoscopic limited excision of large intestine with anastomosis
32003-03 Laparoscopic right hemicolectomy with anastomosis
32004-00 Subtotal colectomy with formation of stoma
32004-01 Extended right hemicolectomy with formation of stoma
32004-02 Laparoscopic subtotal colectomy with formation of stoma
32004-03 Laparoscopic extended right hemicolectomy with formation of stoma
32005-00 Subtotal colectomy with anastomosis
32005-01 Extended right hemicolectomy with anastomosis
32005-02 Laparoscopic subtotal colectomy with anastomosis
32005-03 Laparoscopic extended right hemicolectomy with anastomosis
32006-00 Left hemicolectomy with anastomosis
32006-01 Left hemicolectomy with formation of stoma
32006-02 Laparoscopic left hemicolectomy with anastomosis
32006-03 Laparoscopic left hemicolectomy with formation of stoma
32009-00 Total colectomy with ileostomy
32009-01 Laparoscopic total colectomy with ileostomy
32012-00 Total colectomy with ileorectal anastomosis
32012-01 Laparoscopic total colectomy with ileorectal anastomosis
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Primary outcome(s): Costs of complications (as a composite outcome) following Colon resections.
Costs of complications defined as cost of patients with complications less the cost of patients without complications (ie by comparison of patients with and without complications). All costs related to the index admission for colon resection and any consequent readmissions are included. Costs related to preoperative course are not considered. Allocation of costs will be calculated using an activity-based costing methodology. Only in-hospital costs are considered, with both direct and indirect costs assessed to produce a total cost for each patient. Costs for each patient will be obtained from the Austin Health Department of Finance, which maintain an itemised prospective database of all hospital expenses related to each patient.[Costs will be calculated from day of surgery to hospital discharge. Readmissions are considered within 30 days of discharge from the index admission.]
Study Design: Purpose: Natural history;Duration: Longitudinal;Selection: Defined population;Timing: Retrospective
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