ASSOCIATION BETWEEN INTRA- AND POST-OPERATIVE SURGICAL COMPLICATIONS AND HEALTH ECONOMIC OUTCOMES IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFT: A RETROSPECTIVE DATABASE ANALYSIS
Author(s)
Barbara H. Johnson, MBA1, Prinieeth Anand d, BE2, Elena Naoumtchik, MS3, Carolina Castagna, MD, PhD4, Najmuddin Gunja, MBA, PhD5, Stephen Johnston, PhD6, Niels-Derrek Schmitz, 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, Norderstedt, Germany
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, Norderstedt, Germany
OBJECTIVES: To quantify the association between selected intra- and post-operative surgical complications and health economic outcomes for patients undergoing coronary artery bypass graft (CABG) in the US.
METHODS: This retrospective observational study used the Premier Healthcare Database. Eligible patients were aged ≥18 years undergoing CABG between 1/2016-12/2024. Surgical complications included bleeding (a composite of either a diagnosis related to acute post-hemorrhagic anemia, hemorrhage, hematoma, and/or a procedure code for transfusion) 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 characteristics (e.g., age, sex), procedural (e.g., admission type, secondary valve replacement), and hospital/provider characteristics (e.g., hospital bed size, teaching status).
RESULTS: Data from 379,180 patients were analyzed; 76% male, mean age 65.9 (SD=9.9) years, having a mean of 3.0 bypasses (SD=1.0). The incidence of bleeding and WD-SSI at index were 56.9% and 0.7%, and at index-through-30-days were 57.6% and 2.6% respectively. After multivariable adjustment, mean LOS among patients with evidence of bleeding and WD-SSI was significantly longer than among patients without ([9.6 v 8.6 days] and [23.9 v 9.1 days], respectively, both p<0.001). Mean 30-day costs among patients with evidence of bleeding and WD-SSI were significantly higher than among patients without ($58,393 v $51,718] and [$101,866 v $55,214], respectively, both p<0.001). Readmission rates among patients with evidence of bleeding and WD-SSI were significantly higher than among patients without ([9.7% v 6.7%] and [55.7% v 7.7%], respectively, both p<0.001).
CONCLUSIONS: In this retrospective study of patients undergoing CABG in the US, surgical complications were common and associated with significant health economic burden.
METHODS: This retrospective observational study used the Premier Healthcare Database. Eligible patients were aged ≥18 years undergoing CABG between 1/2016-12/2024. Surgical complications included bleeding (a composite of either a diagnosis related to acute post-hemorrhagic anemia, hemorrhage, hematoma, and/or a procedure code for transfusion) 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 characteristics (e.g., age, sex), procedural (e.g., admission type, secondary valve replacement), and hospital/provider characteristics (e.g., hospital bed size, teaching status).
RESULTS: Data from 379,180 patients were analyzed; 76% male, mean age 65.9 (SD=9.9) years, having a mean of 3.0 bypasses (SD=1.0). The incidence of bleeding and WD-SSI at index were 56.9% and 0.7%, and at index-through-30-days were 57.6% and 2.6% respectively. After multivariable adjustment, mean LOS among patients with evidence of bleeding and WD-SSI was significantly longer than among patients without ([9.6 v 8.6 days] and [23.9 v 9.1 days], respectively, both p<0.001). Mean 30-day costs among patients with evidence of bleeding and WD-SSI were significantly higher than among patients without ($58,393 v $51,718] and [$101,866 v $55,214], respectively, both p<0.001). Readmission rates among patients with evidence of bleeding and WD-SSI were significantly higher than among patients without ([9.7% v 6.7%] and [55.7% v 7.7%], respectively, both p<0.001).
CONCLUSIONS: In this retrospective study of patients undergoing CABG in the US, surgical 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
EE399
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), STA: Surgery