ASSOCIATION BETWEEN INTRA- AND POST-OPERATIVE SURGICAL COMPLICATIONS AND HEALTH ECONOMIC OUTCOMES IN PATIENTS UNDERGOING SLEEVE GASTRECTOMY: 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 selected intra- and post-operative surgical complications and health economic outcomes for patients undergoing sleeve gastrectomy in the US.
METHODS: This retrospective observational study used the Premier Healthcare Database. Eligible patients were aged ≥18 years undergoing sleeve gastrectomy between 1/2016-12/2024. Complications included bleeding ± anemia, anastomotic/staple line leak, 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 268,168 patients were analyzed. The incidence of bleeding ± anemia, leak, and WD-SSI, at index were 1.4%, 0.8%, 0.2%, and 0.02%, and at index-through-30-days were 1.8%, 1.2%, 0.9%, and 0.3%, respectively. After multivariable adjustment, mean LOS among patients with evidence of bleeding ± anemia, leak, and WD-SSI, was significantly longer than among patients without ([3.3 v 1.4 days], [3.9 v 1.4 days], [6.1 v 1.5 days], and [15.1 v 1.5 days], respectively, all p<0.001). Mean 30-day costs among patients with evidence of bleeding ± anemia, leak, and WD-SSI were significantly higher than among patients without ([$31,312 v $16,770], [$36,699 v $16,806], [$43,524 v $16,815], and [$46,953 v $16,959], respectively, all p<0.001). Readmission rates among patients with evidence of bleeding ± anemia, leak, and WD-SSI were significantly higher than among patients without ([17.2% v 1.7%], [22.5% v 1.7%], [57.0% v 1.5%], and [49.3% v 1.8%], respectively, all p<0.001).
CONCLUSIONS: In this retrospective study of patients undergoing sleeve gastrectomy in the US, surgical complications were associated with significant health economic burden.
METHODS: This retrospective observational study used the Premier Healthcare Database. Eligible patients were aged ≥18 years undergoing sleeve gastrectomy between 1/2016-12/2024. Complications included bleeding ± anemia, anastomotic/staple line leak, 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 268,168 patients were analyzed. The incidence of bleeding ± anemia, leak, and WD-SSI, at index were 1.4%, 0.8%, 0.2%, and 0.02%, and at index-through-30-days were 1.8%, 1.2%, 0.9%, and 0.3%, respectively. After multivariable adjustment, mean LOS among patients with evidence of bleeding ± anemia, leak, and WD-SSI, was significantly longer than among patients without ([3.3 v 1.4 days], [3.9 v 1.4 days], [6.1 v 1.5 days], and [15.1 v 1.5 days], respectively, all p<0.001). Mean 30-day costs among patients with evidence of bleeding ± anemia, leak, and WD-SSI were significantly higher than among patients without ([$31,312 v $16,770], [$36,699 v $16,806], [$43,524 v $16,815], and [$46,953 v $16,959], respectively, all p<0.001). Readmission rates among patients with evidence of bleeding ± anemia, leak, and WD-SSI were significantly higher than among patients without ([17.2% v 1.7%], [22.5% v 1.7%], [57.0% v 1.5%], and [49.3% v 1.8%], respectively, all p<0.001).
CONCLUSIONS: In this retrospective study of patients undergoing sleeve gastrectomy 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
EE397
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), STA: Surgery