ASSOCIATION BETWEEN INTRA- AND POST-OPERATIVE SURGICAL COMPLICATIONS AND HEALTH ECONOMIC OUTCOMES IN PATIENTS UNDERGOING ROUX-EN-Y GASTRIC BYPASS: A RETROSPECTIVE DATABASE ANALYSIS
Author(s)
Barbara H. Johnson, MBA1, Anushka Bakore, BE2, Elena Naoumtchik, MS3, Carolina Castagna, MD, MPH4, 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: To quantify the association between the most frequent intra- and post-operative surgical complications and health economic outcomes for patients undergoing Roux-en-Y gastric bypass (RYGB) in the US.
METHODS: This retrospective observational study used the Premier Healthcare Database. Eligible patients were aged ≥18 years undergoing RYGB between 1/2016-12/2024. Surgical complications included bleeding ± anemia, anastomotic leak (AL), and a composite of wound dehiscence/surgical site infection (WD-SSI). 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 105,747 patients were analyzed. The incidence of bleeding ± anemia, AL, and WD-SSI at index were 2.8%, 1.4%, 1.0%, and 0.1%, and at index-through-30-days were 3.8%, 2.4%, 3.0%, and 0.8% respectively. After multivariable adjustment, mean LOS among patients with evidence of bleeding ± anemia, AL, and WD-SSI was significantly longer than among patients without ([4.1 v 1.7 days], [4.9 v 1.7 days], [7.7 v 1.7 days], and [16.7 v 1.7 days], respectively, all p<0.001). Mean 30-day costs among patients with evidence of bleeding ± anemia, AL, and WD-SSI were significantly higher than among patients without ([$41,913 v $22,652], [$46,374 v $22,835], [$57,527 v $22,300], and [$73,528 v $22,990], respectively, all p<0.001). Readmission rates among patients with evidence of bleeding ± anemia, AL, and WD-SSI were significantly higher than among patients without ([22.8% v 3.5%], [28.4% v 3.6%], [51.8% v 2.7%], and [48.1% v 3.9%], respectively, all p<0.001).
CONCLUSIONS: In this retrospective study of patients undergoing Roux-en-Y gastric bypass in the US, surgical complications were not uncommon and associated with significant health economic burden.
METHODS: This retrospective observational study used the Premier Healthcare Database. Eligible patients were aged ≥18 years undergoing RYGB between 1/2016-12/2024. Surgical complications included bleeding ± anemia, anastomotic leak (AL), and a composite of wound dehiscence/surgical site infection (WD-SSI). 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 105,747 patients were analyzed. The incidence of bleeding ± anemia, AL, and WD-SSI at index were 2.8%, 1.4%, 1.0%, and 0.1%, and at index-through-30-days were 3.8%, 2.4%, 3.0%, and 0.8% respectively. After multivariable adjustment, mean LOS among patients with evidence of bleeding ± anemia, AL, and WD-SSI was significantly longer than among patients without ([4.1 v 1.7 days], [4.9 v 1.7 days], [7.7 v 1.7 days], and [16.7 v 1.7 days], respectively, all p<0.001). Mean 30-day costs among patients with evidence of bleeding ± anemia, AL, and WD-SSI were significantly higher than among patients without ([$41,913 v $22,652], [$46,374 v $22,835], [$57,527 v $22,300], and [$73,528 v $22,990], respectively, all p<0.001). Readmission rates among patients with evidence of bleeding ± anemia, AL, and WD-SSI were significantly higher than among patients without ([22.8% v 3.5%], [28.4% v 3.6%], [51.8% v 2.7%], and [48.1% v 3.9%], respectively, all p<0.001).
CONCLUSIONS: In this retrospective study of patients undergoing Roux-en-Y gastric bypass in the US, surgical complications were not uncommon 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
EE291
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), STA: Surgery