ECONOMIC AND CLINICAL BURDEN OF BLEEDING AMONG PATIENTS UNDERGOING METABOLIC/BARIATRIC SURGERY IN THE UNITED STATES
Author(s)
Tammy Kindel, MD, PhD1, Andrew Kim, MD1, Mosadoluwa Afolabi, MPH2, Amitha Kumar, BS, MBA, MS3, Prathiksha N V, BE4, Dominique Medaglio, PharmD, PhD5, Walter A. Danker III, PhD6, Stephen Johnston, PhD7;
1Medical College of Wisconsin, Milwaukee, WI, USA, 2Johnson & Johnson, Gibsonton, FL, USA, 3Ethicon Inc., Summit, NJ, USA, 4Mu Sigma, Bangalore, India, 5Johnson & Johnson, New Brunswick, NJ, USA, 6Ethicon Inc., Raritan, NJ, USA, 7Johnson & Johnson, Sr. Director, Annapolis, MD, USA
1Medical College of Wisconsin, Milwaukee, WI, USA, 2Johnson & Johnson, Gibsonton, FL, USA, 3Ethicon Inc., Summit, NJ, USA, 4Mu Sigma, Bangalore, India, 5Johnson & Johnson, New Brunswick, NJ, USA, 6Ethicon Inc., Raritan, NJ, USA, 7Johnson & Johnson, Sr. Director, Annapolis, MD, USA
OBJECTIVES: To compare economic and clinical outcomes between patients with vs. without bleeding during metabolic/bariatric surgery (MBS) in the United States.
METHODS: This was a retrospective analysis of the Premier Healthcare Database, which comprises electronic health record and administrative data from over 1,000 hospitals in the U.S. Study patients were age ≥18 with a hospital encounter for MBS (Roux-en-Y gastric bypass or sleeve gastrectomy) carrying a primary diagnosis of obesity between 1-Jan-2024 and 31-Dec-2024 (first encounter for MBS during this period = index encounter). Patients were grouped by presence vs. absence of bleeding (diagnosis and/or intervention for bleeding). Outcomes evaluated during the index encounter included hospital length of stay (LOS), total costs borne by the hospital, and incidence proportion of bleeding/transfusion-associated complications (venous thromboembolism, cardiac events, renal failure, and infection); 30-day all-cause inpatient readmission to the hospital in which the index encounter occurred was also evaluated. Multivariable generalized linear models were used to examine the association of bleeding with outcomes, adjusting for patient, procedure, and hospital/provider characteristics; models accounted for hospital-level clustering using robust standard errors.
RESULTS: The study included 29,381 patients (10,419 Roux-en-Y gastric bypass, 18,962 sleeve gastrectomy); 83.2% female, mean (median) age 42.9 (42) years. Overall, 826 (2.8%) patients experienced bleeding during the index encounter. As compared with no bleeding, bleeding was significantly associated with greater LOS (1.1 vs. 1.8 days, p=0.037), total hospital costs ($14,876 vs. $20,566, p<0.001), odds of bleeding/transfusion-associated complications (odds ratio = 3.37, 95% confidence interval 1.69 - 6.33, p<0.001), and odds of 30-day all-cause inpatient readmission (odds ratio = 1.78, 95% confidence interval 1.14 - 2.79, p = 0.011).
CONCLUSIONS: In this large study of patients undergoing MBS in the United States, bleeding was associated with substantial economic and clinical burden. These findings emphasize the need for more effective and timely intervention for surgical bleeding events.
METHODS: This was a retrospective analysis of the Premier Healthcare Database, which comprises electronic health record and administrative data from over 1,000 hospitals in the U.S. Study patients were age ≥18 with a hospital encounter for MBS (Roux-en-Y gastric bypass or sleeve gastrectomy) carrying a primary diagnosis of obesity between 1-Jan-2024 and 31-Dec-2024 (first encounter for MBS during this period = index encounter). Patients were grouped by presence vs. absence of bleeding (diagnosis and/or intervention for bleeding). Outcomes evaluated during the index encounter included hospital length of stay (LOS), total costs borne by the hospital, and incidence proportion of bleeding/transfusion-associated complications (venous thromboembolism, cardiac events, renal failure, and infection); 30-day all-cause inpatient readmission to the hospital in which the index encounter occurred was also evaluated. Multivariable generalized linear models were used to examine the association of bleeding with outcomes, adjusting for patient, procedure, and hospital/provider characteristics; models accounted for hospital-level clustering using robust standard errors.
RESULTS: The study included 29,381 patients (10,419 Roux-en-Y gastric bypass, 18,962 sleeve gastrectomy); 83.2% female, mean (median) age 42.9 (42) years. Overall, 826 (2.8%) patients experienced bleeding during the index encounter. As compared with no bleeding, bleeding was significantly associated with greater LOS (1.1 vs. 1.8 days, p=0.037), total hospital costs ($14,876 vs. $20,566, p<0.001), odds of bleeding/transfusion-associated complications (odds ratio = 3.37, 95% confidence interval 1.69 - 6.33, p<0.001), and odds of 30-day all-cause inpatient readmission (odds ratio = 1.78, 95% confidence interval 1.14 - 2.79, p = 0.011).
CONCLUSIONS: In this large study of patients undergoing MBS in the United States, bleeding was associated with substantial economic and clinical burden. These findings emphasize the need for more effective and timely intervention for surgical bleeding events.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE227
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)