ASSOCIATION BETWEEN INTRA- AND POST-OPERATIVE SURGICAL COMPLICATIONS AND HEALTH ECONOMIC OUTCOMES IN PATIENTS UNDERGOING MINIMALLY INVASIVE TOTAL HYSTERECTOMY: 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 the most frequent intra- and post-operative surgical complications and health economic outcomes for patients undergoing minimally invasive (MI) total hysterectomy in the US.
METHODS: This was a retrospective observational study using the Premier Healthcare Database. Eligible patients were aged ≥18 years undergoing total hysterectomy using an MI approach between 1/2016-12/2024. Surgical complications included bleeding, transfusion, infection, and bladder/ureteral injury. Outcomes included length of stay (LOS), total hospital costs through 30-days post-discharge (30-day costs), and all-cause 30-day readmissions. Multivariable generalized linear models were used to quantify the association of surgical complications (measured at index for LOS and at index through 30 days for 30-day costs and readmissions) with the study outcomes, adjusting for patient, procedural, hospital, and provider characteristics.
RESULTS: Data from 646,897 patients were analyzed. The incidence of bleeding, transfusion, infection, and bladder/ureteral injury at index were 1.1%, 0.3%, 0.1% and 0.8% and at index-through-30-days were 2.0%, 0.4%, 1.0%, and 0.8%, respectively. After multivariable adjustment, mean LOS among patients with evidence of bleeding, transfusion, infection, and bladder/ureteral injury was significantly longer than among patients without ([1.8 v 1.2 days], [2.4 v 1.2 days], [4.2 v 1.2 days], and [1.4 v 1.2 days], respectively, all p<0.001). Mean 30-day costs among patients with evidence of bleeding, transfusion, infection, and bladder/ureteral injury were significantly higher than among patients without ([$16,866 v $11,107], [$22,801 v $11,166], [$22,891 v $11,101], and [$13,893 v $11,205], respectively, all p<0.001). Readmission rates among patients with evidence of bleeding, transfusion, infection, and bladder/ureteral injury were significantly higher than among patients without ([17.1% v 1.5%], [21.2% v 1.7%], [68.7% v 1.1%], and [5.5% v 1.8%], respectively, all p<0.001).
CONCLUSIONS: In this retrospective study of patients undergoing MI total hysterectomy in the US, surgical complications were associated with significant health economic burden.
METHODS: This was a retrospective observational study using the Premier Healthcare Database. Eligible patients were aged ≥18 years undergoing total hysterectomy using an MI approach between 1/2016-12/2024. Surgical complications included bleeding, transfusion, infection, and bladder/ureteral injury. Outcomes included length of stay (LOS), total hospital costs through 30-days post-discharge (30-day costs), and all-cause 30-day readmissions. Multivariable generalized linear models were used to quantify the association of surgical complications (measured at index for LOS and at index through 30 days for 30-day costs and readmissions) with the study outcomes, adjusting for patient, procedural, hospital, and provider characteristics.
RESULTS: Data from 646,897 patients were analyzed. The incidence of bleeding, transfusion, infection, and bladder/ureteral injury at index were 1.1%, 0.3%, 0.1% and 0.8% and at index-through-30-days were 2.0%, 0.4%, 1.0%, and 0.8%, respectively. After multivariable adjustment, mean LOS among patients with evidence of bleeding, transfusion, infection, and bladder/ureteral injury was significantly longer than among patients without ([1.8 v 1.2 days], [2.4 v 1.2 days], [4.2 v 1.2 days], and [1.4 v 1.2 days], respectively, all p<0.001). Mean 30-day costs among patients with evidence of bleeding, transfusion, infection, and bladder/ureteral injury were significantly higher than among patients without ([$16,866 v $11,107], [$22,801 v $11,166], [$22,891 v $11,101], and [$13,893 v $11,205], respectively, all p<0.001). Readmission rates among patients with evidence of bleeding, transfusion, infection, and bladder/ureteral injury were significantly higher than among patients without ([17.1% v 1.5%], [21.2% v 1.7%], [68.7% v 1.1%], and [5.5% v 1.8%], respectively, all p<0.001).
CONCLUSIONS: In this retrospective study of patients undergoing MI total hysterectomy in the US, surgical complications were 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
EE292
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Reproductive & Sexual Health, STA: Surgery