CLINICAL AND ECONOMIC BURDEN ASSOCIATED WITH PROLONGED AIR LEAKS AMONG PATIENTS UNDERGOING LOBECTOMY: A RETROSPECTIVE DATABASE ANALYSIS
Author(s)
Barbara H. Johnson, MBA1, Prinieeth Anand d, BE2, Elena Naoumtchik, MS3, Carolina Castagna, MD, PhD4, Stephen Johnston, PhD5, Gianluca Casali, MD4;
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, 5Johnson & Johnson, Annapolis, MD, USA
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, 5Johnson & Johnson, Annapolis, MD, USA
OBJECTIVES: Prolonged air leak (PAL), typically defined as an air leak persisting longer than five days post-operatively, is one of the most serious complications following thoracic resection. The objective of this study was to estimate the incremental economic and clinical burden of PAL among patients undergoing lobectomy using a large US healthcare database.
METHODS: This was a retrospective observational study using the Premier Healthcare Database. Eligible patients were age ≥18 years and had an inpatient hospital encounter for lobectomy between 1/1/2016-12/31/24 (first=index). PAL was defined by a diagnosis of postprocedural air leak or postprocedural pneumothorax with length of stay (LOS) exceeding 5 days post-lobectomy procedure. Outcomes included, intensive care unit (ICU) stay, post-procedural LOS, total hospital costs during index and through 30-days post-discharge, and all-cause 30-day readmission. Generalized linear models were used to examine the association of PAL with the outcomes, accounting for hospital-level clustering and adjusting for patient demographics and clinical characteristics (e.g., age, sex, race, malignancy), procedural (e.g., admission type, surgical approach, lobe location of resection), and hospital/provider characteristics (e.g., hospital bed size, teaching status, procedural volume).
RESULTS: A total of 59,327 subjects were included for study: 55.1% females, mean (SD) age of 66.8 (10.3) years. Overall, 8.8% had evidence of PAL, which was associated with significant incremental increases in ICU stay (0.86 days, p<0.001, 2.1 vs. 1.3 days), LOS (5.0 days, p<0.001, 10.1 vs. 5.1 days), incremental total index hospital cost ($12,684, p<0.001, $41,777 vs. $29,093), and incremental 30-day hospital cost ($13,620, p<0.001, $44,722 vs. $31,102). Additionally, having PAL significantly increased the risk of being readmitted at 30 days by 3.5% (a 50.0% increase from 6.9% to 10.4%, p<0.001).
CONCLUSIONS: This analysis demonstrates that PAL was associated with substantial patient clinical and economic burden among patients undergoing lobectomy, emphasizing a greater need for preventative measures to reduce the risk of PAL.
METHODS: This was a retrospective observational study using the Premier Healthcare Database. Eligible patients were age ≥18 years and had an inpatient hospital encounter for lobectomy between 1/1/2016-12/31/24 (first=index). PAL was defined by a diagnosis of postprocedural air leak or postprocedural pneumothorax with length of stay (LOS) exceeding 5 days post-lobectomy procedure. Outcomes included, intensive care unit (ICU) stay, post-procedural LOS, total hospital costs during index and through 30-days post-discharge, and all-cause 30-day readmission. Generalized linear models were used to examine the association of PAL with the outcomes, accounting for hospital-level clustering and adjusting for patient demographics and clinical characteristics (e.g., age, sex, race, malignancy), procedural (e.g., admission type, surgical approach, lobe location of resection), and hospital/provider characteristics (e.g., hospital bed size, teaching status, procedural volume).
RESULTS: A total of 59,327 subjects were included for study: 55.1% females, mean (SD) age of 66.8 (10.3) years. Overall, 8.8% had evidence of PAL, which was associated with significant incremental increases in ICU stay (0.86 days, p<0.001, 2.1 vs. 1.3 days), LOS (5.0 days, p<0.001, 10.1 vs. 5.1 days), incremental total index hospital cost ($12,684, p<0.001, $41,777 vs. $29,093), and incremental 30-day hospital cost ($13,620, p<0.001, $44,722 vs. $31,102). Additionally, having PAL significantly increased the risk of being readmitted at 30 days by 3.5% (a 50.0% increase from 6.9% to 10.4%, p<0.001).
CONCLUSIONS: This analysis demonstrates that PAL was associated with substantial patient clinical and economic burden among patients undergoing lobectomy, emphasizing a greater need for preventative measures to reduce the risk of PAL.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE183
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, STA: Surgery