Post-Operative ICU Admission and SOFA Score Assessment after Elective Surgery: A Comparative Case Study of Laparoscopic and Robot-Assisted Low Anterior Resection
Author(s)
Shin M1, Lin PL2
1Intuitive Surgical, Sunnyvale, CA, USA, 2Intuitive Surgical, Sunnyvale, CA, USA
Presentation Documents
OBJECTIVES:
A use of Intensive Care Unit (ICU) and Sequential Organ Failure Assessment (SOFA) score, a scoring system to assess the level of organ dysfunction/failure, after surgery can be a predictor of post-operative outcomes. We conducted a study comparing the differences of ICU admissions, cost of ICU patients and SOFA scores by surgical modality to investigate the impact of surgical modality on surgical outcomes.METHODS:
We used a nationwide Japanese claim database (Medial Data Vision Data) to identify adult patients who underwent Low Anterior Resection (LAR) between April 2018 and June 2022 in hospitals with over 500 beds. The ICU patients were identified using claim codes (A3011, A3012) and divided into Laparoscopic (LAP) and Robot assisted surgery (RAS) groups. We used Propensity Score Matching (PSM) to balance covariates of studied population.RESULTS:
A total of 6,671 low anterior resection patients were identified (LAP: 4,692, RAS: 1,979) and of which 510 patients (LAP: 255, RAS:255) were included after matching. The ICU admission rate was 10% (471/4221) in LAP and 13.5% (268/1711) in RAS (p= .000). Length of ICU stay was 2.42±1.57 in LAP and 2.06±0.79 in RAS (p = 0.001). The SOFA score on the ICU admission date was 10.22±9.17 in LAP and 3.68±3.62 in RAS (p< 0.001), and 10.25±15.21 in LAP and 2.49±5.53 in RAS (p<0.001) on the discharge date. The average hospitalization cost of ICU admitted patients was JPY 2,654,469 for LAP and JPY 2,331,454 for RAS (p=0.003).CONCLUSIONS:
The ICU admission rate was higher in RAS than LAP, but a significantly lower SOFA score was observed in RAS on both admission and discharge date along with saving cost. Due to inherent limitation of claims, we were not able to identify if more routine ICU admission was required to RAS than LAP, and therefore cautious interpretation of the finding is required.Conference/Value in Health Info
2023-05, ISPOR 2023, Boston, MA, USA
Value in Health, Volume 26, Issue 6, S2 (June 2023)
Code
CO207
Topic
Clinical Outcomes, Medical Technologies, Real World Data & Information Systems
Topic Subcategory
Clinical Outcomes Assessment, Health & Insurance Records Systems, Medical Devices
Disease
Medical Devices, Oncology, Surgery
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