ASSOCIATION BETWEEN INTRA- AND POST-OPERATIVE SURGICAL COMPLICATIONS AND HEALTH ECONOMIC OUTCOMES IN PATIENTS UNDERGOING CESAREAN DELIVERY: A RETROSPECTIVE DATABASE ANALYSIS
Author(s)
Barbara H. Johnson, MBA1, Sujith Kumar, BE2, Elena Naoumtchik, MS3, Carolina Castagna, MD, MPH4, 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: Cesarean section (C-section) is the most common major operating room procedure in the US, with rates continuing to increase over time. This study quantified the association between intra- and post-operative surgical complications and health economic outcomes for patients undergoing C-section in the US.
METHODS: This was a retrospective observational study using the Premier Healthcare Database. Eligible patients were aged 18-49 who underwent C-section delivery between 1/2016-12/2022 (first C-section=index). Surgical complications included a composite of wound dehiscence and surgical site infection (WD-SSI), bleeding, and transfusion. Outcomes included postoperative length of stay (LOS), total hospital 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 total hospital costs and at index through 30 days for readmissions) with the study outcomes, adjusting for patient, procedural, hospital, and provider characteristics.
RESULTS: Data from 1,742,269 patients were analyzed. The incidence of WD-SSI, bleeding, and transfusion at index were 0.2%, 4.8%, and 2.1% and at index-through-30-days were 1.3%, 5.4%, and 2.2%, respectively. After multivariable adjustment, mean LOS among patients with evidence of WD-SSI, bleeding, and transfusion was significantly longer than among patients without ([5.7 v 3.3 days], [4.1 v 3.3 days], and [4.5 v 3.3 days], respectively, all p<0.001). Mean total hospital costs among patients with evidence of WD-SSI, bleeding, and transfusion were significantly higher than among patients without ([$18,868 v $10,976], [$15,133 v $10,763], and [$16,886 v $10,849], respectively, all p<0.001). Readmission rates among patients with evidence of WD-SSI, bleeding, and transfusion were significantly higher than among patients without ([27.9% v 3.0%], [8.1% v 3.0%], and [8.6% v 3.2%], respectively, all p<0.001).
CONCLUSIONS: In this very large retrospective study of patients undergoing C-section delivery in the US, surgical complications were common and associated with significant health economic burden.
METHODS: This was a retrospective observational study using the Premier Healthcare Database. Eligible patients were aged 18-49 who underwent C-section delivery between 1/2016-12/2022 (first C-section=index). Surgical complications included a composite of wound dehiscence and surgical site infection (WD-SSI), bleeding, and transfusion. Outcomes included postoperative length of stay (LOS), total hospital 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 total hospital costs and at index through 30 days for readmissions) with the study outcomes, adjusting for patient, procedural, hospital, and provider characteristics.
RESULTS: Data from 1,742,269 patients were analyzed. The incidence of WD-SSI, bleeding, and transfusion at index were 0.2%, 4.8%, and 2.1% and at index-through-30-days were 1.3%, 5.4%, and 2.2%, respectively. After multivariable adjustment, mean LOS among patients with evidence of WD-SSI, bleeding, and transfusion was significantly longer than among patients without ([5.7 v 3.3 days], [4.1 v 3.3 days], and [4.5 v 3.3 days], respectively, all p<0.001). Mean total hospital costs among patients with evidence of WD-SSI, bleeding, and transfusion were significantly higher than among patients without ([$18,868 v $10,976], [$15,133 v $10,763], and [$16,886 v $10,849], respectively, all p<0.001). Readmission rates among patients with evidence of WD-SSI, bleeding, and transfusion were significantly higher than among patients without ([27.9% v 3.0%], [8.1% v 3.0%], and [8.6% v 3.2%], respectively, all p<0.001).
CONCLUSIONS: In this very large retrospective study of patients undergoing C-section delivery 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
EE503
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Reproductive & Sexual Health, STA: Surgery