ASSOCIATION BETWEEN INTRA- AND POST-OPERATIVE HEMOSTASIS-RELATED COMPLICATIONS AND HEALTH ECONOMIC OUTCOMES IN PATIENTS UNDERGOING MYOMECTOMY: A RETROSPECTIVE DATABASE ANALYSIS
Author(s)
Barbara H. Johnson, MBA1, Sujith Kumar, BE2, Elena Naoumtchik, MS3, Carolina Castagna, MD, PhD4, Najmuddin Gunja, MBA, PhD5, Stephen Johnston, PhD6, Giovanni A. Tommaselli, MD7;
1Johnson & Johnson, Associate Director, MedTech Epidemiology and Real World Data Sciences, Lincoln, NH, USA, 2Mu Sigma, Bangalore, India, 3Johnson & Johnson, Markham, ON, Canada, 4Johnson & Johnson, Raritan, NJ, USA, 5J&J Medical Devices, Markham, ON, Canada, 6Johnson & Johnson, Annapolis, MD, USA, 7Johnson & Johnson, Zug, Switzerland
1Johnson & Johnson, Associate Director, MedTech Epidemiology and Real World Data Sciences, Lincoln, NH, USA, 2Mu Sigma, Bangalore, India, 3Johnson & Johnson, Markham, ON, Canada, 4Johnson & Johnson, Raritan, NJ, USA, 5J&J Medical Devices, Markham, ON, Canada, 6Johnson & Johnson, Annapolis, MD, USA, 7Johnson & Johnson, Zug, Switzerland
OBJECTIVES: To quantify the association between intra- and post-operative hemostasis-related complications and health economic outcomes for patients undergoing myomectomy in the US.
METHODS: This was a retrospective observational study using the Premier Healthcare Database. Eligible patients were aged 18+, undergoing myomectomy between 1/2016-12/2024. Hemostasis-related complications included a composite of either a diagnosis related to acute post-hemorrhagic anemia (anemia), hemorrhage, hematoma, and/or a procedure code for transfusion (HR-broad), and the same composite without measuring anemia (HR-narrow). Outcomes included length of stay (LOS), total hospital costs at index admission (index costs), and all-cause 30-day readmissions. Multivariable generalized linear models were used to quantify the association of hemostasis-related complications (measured at index for LOS and index costs and through 30-days for readmissions) with the study outcomes, adjusting for patient, procedural, hospital, and provider characteristics.
RESULTS: Data from 40,314 patients were analyzed; surgical approach 40% laparoscopic and 60% open. The incidence of HR-broad and HR-narrow for laparoscopic/open were 2.0%/17.5% and 1.1%/9.6% at index and 2.4%/17.9% and 1.4%/10.0% at index-through-30-days, respectively. After multivariable adjustment, mean LOS among laparoscopic/open patients with evidence of HR-broad and HR-narrow was significantly longer than among laparoscopic/open patients without ([1.7 v 1.2 days]/ [2.6 v 1.8 days], and [1.8 v 1.3 days]/ [2.8 v 1.9 days] respectively, all p<0.001). Mean index costs among laparoscopic/open patients with evidence of HR-broad and HR-narrow were significantly higher than among laparoscopic/open patients without ($16,832 v $12,829]/ [$14,992 v $10,603], and [$17,710 v $12,857]/ [$16,703 v $10,809], respectively, all p<0.001). Readmission rates among laparoscopic/open patients with evidence of HR-broad and HR-narrow were significantly higher than among laparoscopic/open patients without ([7.7% v 0.6%]/ [3.3% v 1.0%], and [7.7% v 0.7%]/ [3.8% v 1.2%], respectively, all p<0.001).
CONCLUSIONS: In this retrospective study of patients undergoing myomectomy in the US, hemostasis-related complications were common and associated with significant health economic burden.
METHODS: This was a retrospective observational study using the Premier Healthcare Database. Eligible patients were aged 18+, undergoing myomectomy between 1/2016-12/2024. Hemostasis-related complications included a composite of either a diagnosis related to acute post-hemorrhagic anemia (anemia), hemorrhage, hematoma, and/or a procedure code for transfusion (HR-broad), and the same composite without measuring anemia (HR-narrow). Outcomes included length of stay (LOS), total hospital costs at index admission (index costs), and all-cause 30-day readmissions. Multivariable generalized linear models were used to quantify the association of hemostasis-related complications (measured at index for LOS and index costs and through 30-days for readmissions) with the study outcomes, adjusting for patient, procedural, hospital, and provider characteristics.
RESULTS: Data from 40,314 patients were analyzed; surgical approach 40% laparoscopic and 60% open. The incidence of HR-broad and HR-narrow for laparoscopic/open were 2.0%/17.5% and 1.1%/9.6% at index and 2.4%/17.9% and 1.4%/10.0% at index-through-30-days, respectively. After multivariable adjustment, mean LOS among laparoscopic/open patients with evidence of HR-broad and HR-narrow was significantly longer than among laparoscopic/open patients without ([1.7 v 1.2 days]/ [2.6 v 1.8 days], and [1.8 v 1.3 days]/ [2.8 v 1.9 days] respectively, all p<0.001). Mean index costs among laparoscopic/open patients with evidence of HR-broad and HR-narrow were significantly higher than among laparoscopic/open patients without ($16,832 v $12,829]/ [$14,992 v $10,603], and [$17,710 v $12,857]/ [$16,703 v $10,809], respectively, all p<0.001). Readmission rates among laparoscopic/open patients with evidence of HR-broad and HR-narrow were significantly higher than among laparoscopic/open patients without ([7.7% v 0.6%]/ [3.3% v 1.0%], and [7.7% v 0.7%]/ [3.8% v 1.2%], respectively, all p<0.001).
CONCLUSIONS: In this retrospective study of patients undergoing myomectomy in the US, hemostasis-related complications were common and associated with significant health economic burden.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE184
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Reproductive & Sexual Health, STA: Surgery