Appendix online-only tables
Table A1: List of procedures and complications for which search terms were produced
Surgical
Procedures
Surgical complications sought for burden data
segment
Hepatopancreatic

obiliary



Hemihepatectomy
Bile leak, intra-abdominal fluid collection or abscess,
or major liver
haemoperitoneum, incision/wound/surgical site related
resection
complications, surgical site infection
Pancreaticojejuno
Bile/pancreatic leak, biliary anastomotic leak,
stomy
gastroparesis, intra-abdominal fluid collection, need for
Left (distal)
drain/redrain/home drain, pancreatic
pancreatectomy
anastomotic/occlusion failure, pancreatitis,
Whipple procedure
postoperative pancreatic fistula, subhepatic fluid
collection, vascular anastomosis
Urology

Partial
Urine leakage, urinoma, splenic injury
nephrectomy

Radical
Lymphorrhea, anastomotic leakage,
prostatectomy
asymptomatic/symptomatic/infected lymphocele,
obturator nerve injury, ureteral resection, damage of
erectile nerve
Gynaecology

Endometriosis
Anastomotic/suture leakage (open surgery), anaemia,
resection
bladder perforation/injury, (ureteral, vaginoperitoneal,

Hysterectomy
vesicovaginal) fistula, lymphedema,

Pelvic
lymphocyst/lymphocele, lymphorrhea, pelvic abscess,
lymphadenectomy
perforation/injury (bowel and bladder) seroma,
ureter/ureteric injury, ureteral stricture, wound
dehiscence
1
Thoracic



Lobectomy
(Prolonged) air leak, chest tube drainage,
(including
pneumothorax, incomplete inflation of the lung,
bilobectomy)
atelectasis, bronchopleural fistula, empyema,
Atypic lung
mechanical ventilation, pneumonia, pulmonary
resection
embolism, re-intubation
Mediastinal lymph
node dissection
General

All above
Blood loss, haemorrhage, transfusions required,
procedures
haematoma, mortality, haemoglobin changes, postoperative infection, wound infection/abscess
Table A2: Details of Medline search
Searches
Results
1
Cost benefit analysis/
54191
2
Cost of illness/
15130
3
Financial management/
15025
4
Health care cost/
23216
5
Hospital cost/
6853
6
cost$.tw.
304563
(length and stay).mp. [mp=title, abstract, original title, name of substance word, subject heading
7
word, protocol supplementary concept, rare disease supplementary concept, unique identifier]
68237
(duration and stay).mp. [mp=title, abstract, original title, name of substance word, subject heading
8
word, protocol supplementary concept, rare disease supplementary concept, unique identifier]
13840
(resource adj3 us*).mp. [mp=title, abstract, original title, name of substance word, subject heading
9
word, protocol supplementary concept, rare disease supplementary concept, unique identifier]
6569
2
hospitali*.mp. [mp=title, abstract, original title, name of substance word, subject heading word,
10
protocol supplementary concept, rare disease supplementary concept, unique identifier]
175950
11
"Costs and Cost Analysis"/
39817
12
emergency health service/ or emergency care/
29194
(resource* adj3 utili*).mp. [mp=title, abstract, original title, name of substance word, subject
13
heading word, protocol supplementary concept, rare disease supplementary concept, unique
6334
identifier]
(resource* adj2 us*).mp. [mp=title, abstract, original title, name of substance word, subject
14
heading word, protocol supplementary concept, rare disease supplementary concept, unique
10466
identifier]
15
"length of stay"/
50773
16
Outpatient Clinics, Hospital/
13745
17
1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16
622655
18
exp postoperative complication/
384246
19
exp Peroperative Complication/
33253
20
exp Intraoperative Complications/
33253
21
complication$.mp.
872239
22
adverse event*.mp.
60848
23
18 or 19 or 20 or 21 or 22
1031431
24
bleeding/
47793
25
abscess/ or subphrenic abscess/ or abdominal abscess/ or pelvis abscess/ or perirenal abscess/
24095
26
wound infection/ or postoperative infection/ or surgical infection/
8765
27
infection/ or urogenital tract infection/ or lung infection/ or hospital infection/ or lower respiratory
tract infection/ or urinary tract infection/ or abdominal infection/ or secondary infection/ or biliary
99729
3
tract infection/
(abdominal adj2 collection).mp. [mp=title, abstract, original title, name of substance word, subject
28
heading word, protocol supplementary concept, rare disease supplementary concept, unique
119
identifier]
29
injury/ or nerve injury/ or nervous system injury/ or surgical injury/
82756
30
anemia/
30951
31
atelectasis/
5296
32
bacteremia/
15659
33
intestine injury/ or bowel injury.mp.
743
34
fluid collection.mp. or abdominal abscess/
3419
35
empyema/
3352
36
wound dehiscence/ or anastomosis dehiscence/ or dehiscence.mp.
11150
(nerve adj3 injur*).mp. [mp=title, abstract, original title, name of substance word, subject heading
37
word, protocol supplementary concept, rare disease supplementary concept, unique identifier]
21355
38
hemoperitoneum/
2635
39
lymphocele.mp.
1094
40
lymphocyst.mp.
123
41
lymphorrhea.mp.
160
42
lymphorrhagia.mp.
19
43
abscess.mp.
60935
44
pneumonia/
34051
(resect* adj4 ureter*).mp. [mp=title, abstract, original title, name of substance word, subject
45
heading word, protocol supplementary concept, rare disease supplementary concept, unique
648
identifier]
4
46
urinoma/
50
47
leak*.ti,ab.
64509
48
wound infection/ or wound complication/
8765
49
stricture*.ti,ab.
18786
50
(failure adj3 anastomo*).ti,ab.
395
51
fistula*.ti,ab.
65647
52
gastroparesis.ti,ab.
1369
53
hematoma/ or hematoma*.ti,ab.
37316
54
haemorrhage.ti,ab.
24240
55
hemorrhage.ti,ab.
87848
56
Lymphedema.ti,ab.
3917
57
lymphoedema.ti,ab.
1434
58
pancreatic occlusion.mp.
5
59
pneumothorax/
12003
60
Vascular anastomo*.ti,ab.
1529
61
intubation/
4383
62
Respiration, Artificial/
35426
63
drain*.ti,ab.
83369
64
Pancreatitis/
36536
65
Peripheral Nerve Injuries/
3778
(bladder or bowel).mp. and injur*.ti,ab. [mp=title, abstract, original title, name of substance word,
66
subject heading word, protocol supplementary concept, rare disease supplementary concept,
10097
unique identifier]
5
67
Intestinal Perforation/
10185
68
Pulmonary Embolism/
29224
69
or/24-68
833439
70
hepatectomy.mp.
24025
71
pancreaticojejunostomy/
727
72
splenectomy/
17946
73
spleen/
100257
74
lobectomy/
454
75
lymph node dissection/
22329
76
endometriosis/
15352
(excision or resection).mp. [mp=title, abstract, original title, name of substance word, subject
77
heading word, protocol supplementary concept, rare disease supplementary concept, unique
252300
identifier]
78
hysterectomy/
21547
79
76 and 77
1114
(hemi-hepatectomy or hemihepatectomy).mp. [mp=title, abstract, original title, name of substance
80
word, subject heading word, protocol supplementary concept, rare disease supplementary concept,
559
unique identifier]
81
73 and 77
596
(Whipple or Whipple's).mp. [mp=title, abstract, original title, name of substance word, subject
82
heading word, protocol supplementary concept, rare disease supplementary concept, unique
3440
identifier]
((nerve sparing or nerve-sparing) and prostatectomy).mp. [mp=title, abstract, original title, name of
83
substance word, subject heading word, protocol supplementary concept, rare disease
917
supplementary concept, unique identifier]
6
84
radical prostatectomy.mp.
11093
85
Pancreatectomy/
8548
(lobe and resect*).mp. [mp=title, abstract, original title, name of substance word, subject heading
86
word, protocol supplementary concept, rare disease supplementary concept, unique identifier]
7238
(lobectomy and lung).mp. [mp=title, abstract, original title, name of substance word, subject
87
heading word, protocol supplementary concept, rare disease supplementary concept, unique
5831
identifier]
88
hemihepatectomy.ti,ab.
514
89
lung resection.mp.
2505
90
Prostatectomy/
19169
91
Nephrectomy/
25203
92
Lymph Node Excision/
22329
(liver and resect*).mp. [mp=title, abstract, original title, name of substance word, subject heading
93
word, protocol supplementary concept, rare disease supplementary concept, unique identifier]
24089
70 or 71 or 72 or 74 or 75 or 78 or 79 or 80 or 81 or 82 or 83 or 84 or 85 or 86 or 87 or 88 or 89 or 90
94
or 91 or 92 or 93
168416
95
17 and 23 and 69 and 94
1648
96
limit 95 to (humans and yr="2002 -Current" and english)
911
(addresses or autobiography or bibliography or biography or case reports or classical article or
comment or dictionary or directory or editorial or festschrift or historical article or in vitro or
97
interactive tutorial or interview or lectures or legal cases or legislation or letter or news or
3488932
newspaper article or patient education handout or periodical index or portraits or practice guideline
or video-audio media or webcasts).pt.
98
96 not 97
880
limit 98 to ("all infant (birth to 23 months)" or "newborn infant (birth to 1 month)" or "infant (1 to 23
99
months)" or "preschool child (2 to 5 years)" or "child (6 to 12 years)")
66
7
100 98 not 99
814
Table A3: Details of Embase search
Searches
Results
1
Socioeconomics/
98811
2
Cost benefit analysis/
60489
3
Cost effectiveness analysis/
80602
4
Cost of illness/
12985
5
Financial management/
96283
6
Health care cost/
109422
7
Health economics/
30977
8
Hospital cost/
11949
9
cost$.tw.
377088
10
11
12
13
(length and stay).mp. [mp=title, abstract, subject headings, heading word, drug trade name,
original title, device manufacturer, drug manufacturer, device trade name, keyword]
(duration and stay).mp. [mp=title, abstract, subject headings, heading word, drug trade name,
original title, device manufacturer, drug manufacturer, device trade name, keyword]
(resource adj3 us*).mp. [mp=title, abstract, subject headings, heading word, drug trade name,
original title, device manufacturer, drug manufacturer, device trade name, keyword]
hospitali*.mp. [mp=title, abstract, subject headings, heading word, drug trade name, original title,
device manufacturer, drug manufacturer, device trade name, keyword]
82026
27227
8620
286668
14
"Costs and Cost Analysis"/
48041
15
emergency health service/ or emergency care/
70593
16
outpatient department/
33910
17
18
(resource* adj3 utili*).mp. [mp=title, abstract, subject headings, heading word, drug trade name,
original title, device manufacturer, drug manufacturer, device trade name, keyword]
(resource* adj2 us*).mp. [mp=title, abstract, subject headings, heading word, drug trade name,
original title, device manufacturer, drug manufacturer, device trade name, keyword]
9079
13388
8
19
"length of stay"/
63631
20
exp postoperative complication/
429024
21
exp Peroperative Complication/
16504
22
exp perioperative complication/
2994
23
complication$.mp.
948157
24
exp complication/
551710
25
(intraoperative adj3 complication*).mp. [mp=title, abstract, subject headings, heading word, drug
trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword]
9151
26
adverse event*.mp.
90813
27
20 or 21 or 22 or 23 or 24 or 25 or 26
1248441
28
bleeding/
137456
29
abscess/ or subphrenic abscess/ or abdominal abscess/ or pelvis abscess/ or perirenal abscess/
34806
30
wound infection/ or postoperative infection/ or surgical infection/
63605
infection/ or urogenital tract infection/ or lung infection/ or hospital infection/ or lower respiratory
31
tract infection/ or urinary tract infection/ or abdominal infection/ or secondary infection/ or biliary 243069
tract infection/
32
(abdominal adj2 collection).mp. [mp=title, abstract, subject headings, heading word, drug trade
name, original title, device manufacturer, drug manufacturer, device trade name, keyword]
170
33
injury/ or nerve injury/ or nervous system injury/ or surgical injury/
243702
34
acute pancreatitis/
14173
35
anemia/
91840
36
atelectasis/
9073
37
bacteremia/
23936
38
nerve paralysis/
3745
39
bladder injury/
2087
40
bladder perforation/
996
41
intestine injury/ or bowel injury.mp.
5662
9
42
colon injury/
1474
43
fluid collection.mp. or abdominal abscess/
7124
44
empyema/
5891
45
wound dehiscence/ or anastomosis dehiscence/ or dehiscence.mp.
14244
46
nerve injury/
16363
47
(nerve adj3 injur*).mp. [mp=title, abstract, subject headings, heading word, drug trade name,
original title, device manufacturer, drug manufacturer, device trade name, keyword]
33770
48
hemoperitoneum/
4231
49
lymphocele.mp.
1812
50
lymphocyst.mp.
160
51
lymphorrhea.mp.
238
52
lymphorrhagia.mp.
24
53
abscess.mp.
81823
54
pneumonia/
84057
55
(resect* adj4 ureter*).mp. [mp=title, abstract, subject headings, heading word, drug trade name,
original title, device manufacturer, drug manufacturer, device trade name, keyword]
810
56
urinoma/
715
57
leak*.ti,ab.
76141
58
wound infection/ or wound complication/
27351
59
stricture*.ti,ab.
23645
60
(failure adj3 anastomo*).ti,ab.
483
61
fistula*.ti,ab.
75851
62
gastroparesis.ti,ab.
2074
63
hematoma/ or hematoma*.ti,ab.
52269
64
haemorrhage.ti,ab.
29453
65
hemorrhage.ti,ab.
103656
66
Lymphedema.ti,ab.
5081
10
67
lymphoedema.ti,ab.
1834
68
pancreatic occlusion.mp.
6
69
perforation/
5930
70
pneumothorax/
19971
71
lung embolism/
50825
72
seroma/
3184
73
Vascular anastomo*.ti,ab.
1737
74
hepatectomy.mp.
16306
75
pancreas resection/
11917
76
pancreaticojejunostomy/
1408
77
splenectomy/
24125
78
spleen/
84939
79
lung lobectomy/
4419
80
lobectomy/
4894
81
lymph node dissection/
15940
82
endometriosis/
21188
83
(excision or resection).mp. [mp=title, abstract, subject headings, heading word, drug trade name,
original title, device manufacturer, drug manufacturer, device trade name, keyword]
359312
84
hysterectomy/
29000
85
hemihepatectomy/
659
86
82 and 83
1762
(hemi-hepatectomy or hemihepatectomy).mp. [mp=title, abstract, subject headings, heading word,
87
drug trade name, original title, device manufacturer, drug manufacturer, device trade name,
1037
keyword]
88
78 and 83
1222
89
lung resection/
22791
90
radical retropubic prostatectomy/
737
11
91
partial nephrectomy/
3949
92
pelvis lymphadenectomy/
2799
93
(Whipple or Whipple's).mp. [mp=title, abstract, subject headings, heading word, drug trade name,
original title, device manufacturer, drug manufacturer, device trade name, keyword]
3863
((nerve sparing or nerve-sparing) and prostatectomy).mp. [mp=title, abstract, subject headings,
94
heading word, drug trade name, original title, device manufacturer, drug manufacturer, device
1553
trade name, keyword]
95
96
radical prostatectomy.mp.
74 or 75 or 76 or 77 or 79 or 80 or 81 or 84 or 85 or 86 or 87 or 88 or 89 or 90 or 91 or 92 or 93 or 94
or 95
16448
151819
97
(book or book series or editorial or letter or note or trade journal).pt.
1792209
98
liver resection/
24499
99
96 or 98
165507
100 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19
1094940
28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 or 38 or 39 or 40 or 41 or 42 or 43 or 44 or 45
101 or 46 or 47 or 48 or 49 or 50 or 51 or 52 or 53 or 54 or 55 or 56 or 57 or 58 or 59 or 60 or 61 or 62 or
1267857
63 or 64 or 65 or 66 or 67 or 68 or 69 or 70 or 71 or 72 or 73
102 drain*.ti,ab.
100384
103 artificial ventilation/
70234
104 intubation/
13496
105 101 or 102 or 103 or 104
1393836
106 27 and 99 and 100 and 105
4121
107 limit 106 to (human and yr="2002 -Current")
2808
108 107 not 97
2742
109
limit 108 to (embryo <first trimester> or infant <to one year> or child <unspecified age> or
preschool child <1 to 6 years> or school child <7 to 12 years>)
151
110 108 not 109
2591
111 limit 110 to english
2398
12
Table A4: Details of Econlit search
Searches
Results
1
complication$.mp.
554
2
injury*.mp. [mp=heading words, abstract, title, country as subject]
894
3
anemia.mp. [mp=heading words, abstract, title, country as subject]
37
4
atelectasis.mp. [mp=heading words, abstract, title, country as subject]
0
5
bacteremia.mp. [mp=heading words, abstract, title, country as subject]
0
6
empyema.mp. [mp=heading words, abstract, title, country as subject]
0
7
dehiscence.mp. [mp=heading words, abstract, title, country as subject]
0
8
anastomo*.mp. [mp=heading words, abstract, title, country as subject]
0
9
hemoperitoneum.mp. [mp=heading words, abstract, title, country as subject]
0
10 lymphocele.mp. [mp=heading words, abstract, title, country as subject]
0
11 lymphocyst.mp. [mp=heading words, abstract, title, country as subject]
0
12 lymphorrhea.mp. [mp=heading words, abstract, title, country as subject]
0
13 lymphorrhagia.mp. [mp=heading words, abstract, title, country as subject]
0
14 pneumonia.mp. [mp=heading words, abstract, title, country as subject]
48
15 urinoma.mp. [mp=heading words, abstract, title, country as subject]
0
16 leak*.mp. [mp=heading words, abstract, title, country as subject]
700
17 wound.mp. [mp=heading words, abstract, title, country as subject]
25
18 stricture*.mp. [mp=heading words, abstract, title, country as subject]
55
19 failure.mp. [mp=heading words, abstract, title, country as subject]
9995
13
20 fistula*.mp. [mp=heading words, abstract, title, country as subject]
3
21 gastroparesis.mp. [mp=heading words, abstract, title, country as subject]
0
22 hematoma.mp. [mp=heading words, abstract, title, country as subject]
1
23 haemorrhage.mp. [mp=heading words, abstract, title, country as subject]
4
24 hemorrhage.mp. [mp=heading words, abstract, title, country as subject]
8
25 Lymphedema.mp. [mp=heading words, abstract, title, country as subject]
0
26 lymphoedema.mp. [mp=heading words, abstract, title, country as subject]
0
27 occlusion.mp. [mp=heading words, abstract, title, country as subject]
2
28 pneumothorax.mp. [mp=heading words, abstract, title, country as subject]
1
29 intubation.mp. [mp=heading words, abstract, title, country as subject]
0
30 ventilation.mp. [mp=heading words, abstract, title, country as subject]
28
31 drain*.mp. [mp=heading words, abstract, title, country as subject]
974
32 Pancreatitis.mp. [mp=heading words, abstract, title, country as subject]
0
33 Perforation.mp. [mp=heading words, abstract, title, country as subject]
1
34 Pulmonary Embolism.mp. [mp=heading words, abstract, title, country as subject]
6
35 adverse.mp. [mp=heading words, abstract, title, country as subject]
6704
1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20
36
or 21 or 22 or 23 or 24 or 25 or 26 or 27 or 28 or 29 or 30 or 31 or 32 or 33 or 34 or 35
19727
37 surger*.mp.
304
38 surgical.mp.
212
39 procedure*.mp.
19956
40 operat*.mp.
35783
14
41 resect*.mp.
4
42 laparotom*.mp.
0
43 laparoscop*.mp.
4
44 robot.mp.
76
45 37 or 38 or 39 or 40 or 41 or 42 or 43 or 44
54615
46 36 and 45
1506
47 limit 46 to (yr="2002 -Current" and english)
944
48 limit 47 to (books or book reviews)
26
49 47 not 48
918
15
Table A5: Costs associated with HPB surgery
Study
Comparison group
Pancreaticoduodenectomy
Daskalaki, 2011
No POPF
n
Currency/
cost year¶
Preoperative
Intraoperative
Postoperative
Indirect costs
Total hospital costs
[2013 US$]
408
EUR‡/NR
(1996)
tests and radiological
investigations: 179.6
Operating theatre:
3,567.58
Hospital stay:
3600
radiological imaging:
80
Laboratory:
472.8
Hospital stay:
4,950
radiological imaging:
80
Laboratory:
472.8
Hospital stay:
10,800
Transfusions:
70
Total parenteral or enteral
nutrition:
1,540
Octreotide:
241.65
radiological imaging:
897
Laboratory:
1,141.25
Hospital stay:
20,700
Intensive care:
6500
Reoperation:
2000
Transfusions:
280
1994.48
9665.56 [17886.09]
2404.99
11654.97 [21567.48]
5302.81
25698.24 [47554.52]
12,276.25
59492.64 [110090.96]
Grade A POPF
28
tests and radiological
investigations: 179.6
Operating theatre:
3,567.58
Grade B POPF
104
tests and radiological
investigations: 179.6
Operating theatre:
3,567.58
Grade C POPF
13
tests and radiological
investigations: 179.6
Operating theatre:
3,567.58
16
Study
Fuks, 2009
Haddad, 2009
Topal, 2007
Comparison group
n
Currency/
cost year¶
EUR †/NR
(2005)
Preoperative
Intraoperative
Postoperative
Indirect costs
Total hospital costs
[2013 US$]
-
-
Total parenteral or enteral
nutrition:
3,700
Octreotide:
483.3
radiological imaging:
1,674
Laboratory:
1,815.20
-
-
10406 (5570 - 30999)
[16325 (8738-48634)]
15225 (10171-30685)
[23886 (15957-48141)]
All patients
109
Patients with post
operative pancreatic
fistula (POPF)
14
-
Operation room:
2264 (1007-6475)
Patients with
complications other
than POPF
37
-
Operation room:
2199 (1002-5079)
Hospital stay: 4847 (5207956)
Intensive care: 0 (0-3667)
Emergency: 0(0-87)
Functional measurement: 0
(0-227)
Imaging: 142 (0-512)
Laboratory: 1164 (707-9712)
Medical Staff (unspecified):
2057 (1296-5132)
Paramedical personnel: 259
(0-1035)
Pharmacy: 3140 (2008-7298)
Care logistics: 53 (53-159)
Hospital stay: 3639 (121313493)
Intensive care: 0 (0-7215)
Emergency: 0 (0-499)
Functional measurement: 33
(0-821)
Imaging: 109 (0-685)
Laboratory: 877 (412-5147)
Medical Staff (unspecified):
1950 (1301-5750)
Paramedical personnel: 194
-
-
11393 (6716- 30999)
[17874 (10536-48634)]
17
Study
Vanounou,
2007§
Comparison group
n
Currency/
cost year¶
Preoperative
Intraoperative
Postoperative
Indirect costs
Total hospital costs
[2013 US$]
-
8565 (5569-16921)
[13437 (8737-26547)]
-
7696 (7013-8378)
[12074 (11002-13144)]
Patients without
complications
58
-
Operation room:
2131 (970-6425)
Patients with grade
1 TOSGS-score of
complication
Patients with grade
4 TOSGS-score of
complication
Patients with grade
5 TOSGS-score of
complication
All patients
No pancreatic fistula
or other
complication
Any grade of fistula
Grade A pancreatic
fistula
Grade B pancreatic
fistula
2
-
-
(0-1805)
Pharmacy: 1526 (500-5871)
Care logistics:
0 (0-499)
Hospital stay: 2686 (12137358)
Intensive care: 0 (0-1467)
Emergency: 0 (0-673)
Functional measurement: 0
(0-227)
Imaging: 53 (0-289)
Laboratory: 640 (277-2206)
Medical Staff (unspecified):
1735 (1158-3060)
Paramedical personnel:
0 (0-776)
Pharmacy: 978 (460-4340)
Care logistics: 0 (0-673)
-
NR
-
-
-
-
NR
2
-
-
-
-
19355 (8026-30685)
[30366 (12591-48141)]
-
-
-
-
NR
18,254 [21,357]
NR
26
-
-
-
-
NR
18,235 [21,334]
28
-
-
-
-
30,581 [35,779]
NR
167
US $/NR
(2007)
18
Study
Comparison group
n
Grade C pancreatic
fistula
Pancreatic resection
Casadei, 2011
Glowka, 2010
Jimenez, 2007
Rodriguez, 2006
Pancreatic stump
leak (PL) related
complications
6
22
Currency/
cost year¶
US $/NR
(2004)
Preoperative
Intraoperative
Postoperative
Indirect costs
-
-
-
-
-
-
-
-
Total hospital costs
[2013 US$]
113,084 [132,308]
The average patient with
PL-related problem
incurred a total cost that
was 2.01 times greater
than the average patient
in the no-PL group. This
yielded a cost differential
of $14,179 [17,581],
which was largely
accounted for by
hospital-related costs. A
decision analytic model
developed to evaluate
threshold costs showed
that a hypothetical
intervention designed to
reduce the complication
rate of distal
pancreatectomy by one
third would be financially
justifiable up to a cost of
$1418 [1758] per patient.
Alternatively, an
intervention that reduced
PLs to 0% could cost up
to $4254 [5274] and still
be economically justified.
Many of the PLs were
manifesting as both a
fistula and a sterile
collection, or a fistula
19
Study
Comparison group
n
Currency/
cost year¶
Intraoperative
Postoperative
Indirect costs
Simons, 2009
Pancreaticoduodenectomy and Pancreatectomy (Mixed populations)
Behrman, 2008
Belyaev, 2011
Kent, 2011§
All patients
578
US $/NR
(2009)
No readmission
467
within 30 days (all
resection types)
30-Day readmitted
111
patients (all
resection types)
-
-
-
-
-
-
Initial admission: NR
Initial admission (total
cost): 24,679 [26,900]
-
-
-
Pratt, 2009
-
-
-
-
Initial admission: 30,988
[33,776]
Readmission: 10,159
[11,073]
Overall Hospital costs
(initial surgery +
readmissions): 40,583
[44,235]
NR
Total, including
readmission cost:
17556 (IQR 15176–
22071) [19312 (IQR
16694-24278)]
US $/NR
(2008)
Preoperative
All patients
‘No relevance’
(patients who either
lacked evidence of
fistula or
demonstrated
biochemical
evidence alone)
Evident fistula
405
349
36
-
-
-
-
Latent Fistula
20
-
-
-
-
Type I: subacute
6
-
-
-
-
Total hospital costs
[2013 US$]
and an abscess.
-
Total, including
readmission cost:
23542 (IQR 17337–
43640) [25896 (IQR
19071-48004)]
Total, including
readmission cost:
31750 (IQR 20907–
47743) [34925 (IQR
22998-52517)]
Total, including
20
Study
Comparison group
n
Currency/
cost year¶
Preoperative
Intraoperative
Postoperative
Indirect costs
latent pancreatic
fistula
Type II: acute latent
pancreatic fistula
8
-
-
-
-
Type III: critical
latent pancreatic
fistula
6
-
-
-
-
-
-
-
-
Hepatic resection
Breitenstein,
All patients
2010
615
US $/NR
(2009)
no complications, or
Grade I or II
complications
456
-
-
-
-
grade III or IV
complications
159
-
-
-
-
Score 0-2 (low-risk
of postoperative
complications)
NR
-
-
-
-
Score 3-5
(intermediate risk of
NR
-
-
-
-
Total hospital costs
[2013 US$]
readmission cost:
22873 (IQR 17508–
30248) [25160 (IQR
19259-33273)]
Total, including
readmission cost:
32206 (IQR 19312–
102146) [35427 (IQR
21243-112361)]
Total, including
readmission cost:
40517 (IQR 34864–
107454) [44569 (IQR
38350-118199)]
35,028 (IQR 25,57251,338) †, 51,497
(59,418) ‡ [38531 (IQR
28129-56472) 56647
(65360)]
31,669 (IQR 24,01940,795) †, 36,931
(27,854) ‡ [34836 (IQR
26421-44875) 40624
(30639)]
65,228 (IQR 43,13098,811) †, 94,545
(96,252) ‡ [71751 (IQR
47443-108692) 104000
(105877)]
32,371 (IQR 24,17442,830) †, 43,247
(46,991) ‡ [35608 (IQR
26591-47113) 47572
(51690)]
35,194 (IQR 26,42653,597) †, 51,940
21
Study
Comparison group
n
Currency/
cost year¶
Preoperative
Intraoperative
Postoperative
Indirect costs
-
-
-
-
postoperative
complications)
Score 6-10 (high risk
of postoperative
complications)
NR
Total hospital costs
[2013 US$]
(51,295) ‡ [38713 (IQR
29069-58957) 57134
(56425)]
62,210 (IQR 41,24589,362) †, 86,863
(99,215) ‡ [68431 (IQR
45370-98298) 95549
(109137)]
Abbreviations: NR, not reported
†Median (range), or Median (interquartile range) values reported ‡Mean (sd) or mean (range) reported §Further data is extracted in the accompanying DET file ¶ Where the cost year is not
reported, the year of data collection (or end thereof for ranges) was used (provided in brackets)
22
Table A6: Resource use associated with HPB surgery
Study
Comparison
group
Pancreaticoduodenectomy
Daskalaki, 2011
No POPF
Grade A POPF
Grade B POPF
Grade C POPF
All patients with
POPF
Fuks, 2009
n
Hospital stay
(days)
ICU
days/visits
Re-operation
Blood transfusion
Medication use
Tests/Diagnosis
Other
408
28
104
13
8
11
24
46
-
-
-
-
-
147
680
111
17 (11.6%)
Time to reoperation:
12 days (IQR 12–16.5) from
the PD
percutaneous drainage US-CT
guided for intra-abdominal
collections: 5 (3.4%)
endoscopic procedure due to
hematemesis: 1 (0.7%)
-
-
9 (11%)
-
-
-
-
required percutaneous
drainage for intra-abdominal
collection : 7
21 (30.8%)
-
-
-
reoperation in 35 (97%):
for intra-abdominal collections:
7
emergency surgery for
hemodynamic instability: 2
reoperation with isolated
16 (51.6%)
all Grade B
patients treated
with total
parenteral
nutrition: 32
somatostatin
analogues: 75%
somatostatin
analogues: 73%
Angiography with
embolization: 2
-
Grade A/B
pancreatic fistula
75
19 (IQR 14-27.5)
NR
NR; mean
duration of
drainage output
was 13 (11) days
(range 4–45).
29 (9)
Grade C pancreatic
fistula
36
46 (16)
All patients
All pancreatic
fistula patients
23
Study
Comparison
group
n
Hospital stay
(days)
ICU
days/visits
Re-operation
Blood transfusion
Medication use
Tests/Diagnosis
Other
Intra-operative,
Red blood cells
units: 0.7 (0–12)
Intra-operative,
Red blood cells
units: 0.6 (0–5)
Intra-operative,
Red blood cells
units: 0.7 (0–4)
Intra-operative,
Red blood cells
units: 0.7 (0–12)
-
-
-
-
-
-
-
-
-
-
-
-
-
prophylactic
octreotide was
based on the
judgment of the
surgeon, mainly in
patients with soft
pancreatic texture.
Octreotide
administered with
the intention to
treat in 12/14
patients with
POPF for 7 (5-16)
days.
-
-
-
-
-
elective haemostasis for
bleeding: 14
Haddad, 2009
Topal, 2007
All patients
117
NR
-
surgical pancreatic drainage:
17
percutaneous drainage: 7
NR
No pancreatic
fistula
82
21 (9)
-
0
PF treated
conservatively
21
42 (17.5)
-
0
PF treated
surgically
(relaparotomy)
14
63 (27)
-
All patients
109
17 (7-52) †
2 (1.8%)
All patients were reoperated
(relaparotomy);
completion
splenopancreatectomy: 5
debridement and drainage: 9
6 (5.5%)
Patients with Post
operative
14
26 (10-36) †
-
-
-
24
Study
Vanounou, 2007
Comparison
group
pancreatic fistula
(POPF)
Patients with
complications other
than POPF
Patients without
complications
Patients with grade
1 TOSGS-score of
complication
Patients with grade
4 TOSGS-score of
complication
Patients with grade
5 TOSGS-score of
complication
All patients
No pancreatic
fistula or other
complication
Any grade of fistula
n
Hospital stay
(days)
ICU
days/visits
Re-operation
Blood transfusion
Medication use
Tests/Diagnosis
Other
37
21 (8-52) †
-
-
-
-
-
-
58
14 (7-33) †
-
-
-
-
-
-
2
15 (15-15) †
-
-
-
-
-
-
2
30 (29-31) †
-
-
-
-
-
-
2
NR
-
-
-
-
-
-
227
167
10
9.3
-
-
-
-
-
-
60
NR; but 6 (2.6%)
were readmitted
-
Reoperation: 3 (1.3%)
percutaneous drainage:
(6.7%).
-
-
-
Grade A pancreatic
fistula
Grade B pancreatic
fistula
Grade C pancreatic
fistula
26
8.2
-
-
-
supplemental
nutrition: 15
patients (25.0%)
Antibiotics: 26
(43.3%)
-
-
-
28
12
-
-
-
-
-
-
6
29.7
-
-
-
-
-
-
61
30
9
12.7 [7-118]
9.2(2.2)
10.4(3.0)
-
-
-
-
-
-
Pancreatic resection
Casadei, 2011
All patients
No complication
Grade I
complications
25
Study
Glowka, 2010
Jimenez, 2007
Rodriguez, 2006
Comparison
group
Grade II
complications
Grade III
complications
n
ICU
days/visits
-
Re-operation
Blood transfusion
Medication use
Tests/Diagnosis
Other
15
Hospital stay
(days)
12.3(4.7)
-
-
-
-
-
6
16.8(9.4)
-
-
-
-
-
Grade IV
complications
All patients
No redo surgery
Early redo surgery
1
118
-
-
-
-
53
43
6
-
-
-
-
late redo surgery
4
-
4
-
-
-
-
All patients
Control group stapled (non
reinforced)
Experimental group
- staple line
reinforcement
Pancreatic leak
31
18
21 (7-153)
18 (7-126)
40 (8-126)(initial
stay)
6 (readmission)
22 (10-43)
(4 readmissions)
-
Intensive
care visit: 1
-
radiologic intervention not
under general anaesthesia: 6
(all patients)
underwent surgery under
general anaesthesia: 1
NR
0
6
-
-
-
-
surgical drains
retained:2
13
-
-
Reoperation for leak: 1
interventional radiology
drainage for leak: 3
Reoperation for leak: 0
-
-
-
surgical drains
retained:0
7
13.6 (5–28)
-
-
-
-
surgical drains
retained:2
No pancreatic leak
24
8.33 (5–21)
-
Reoperation for leak: 1
interventional radiology
drainage for leak: 3
Reoperation for leak: 0
-
-
-
All patients
Pancreatic stump
leak (PL) related
complications
66
22
Total (initial +
readmission):
16.6(14.6) [4-49
days]
-
3 (5%)
1: reexplored at 90 days for
persistent intra-abdominal
abscess.
1: Another, who had splenic
preservation, underwent
reexploration at 3.5 months for
splenic infarct and persistent
collection in the splenic hilum.
-
Broad spectrum
antibiotics (at least
one course): 15
(68%), for an
average of 12.6
days (range, 7-24
days)
-
surgical drains
retained:0
Emergency room
visits: 13 (59%),
mean no. of visits:
1.8 (1-6)
Readmitted: 16
(73%); 13.8 (138) days length
of stay for
visiting nurse
services for their
postoperative
care:18 (82%)
26
Study
Comparison
group
n
Hospital stay
(days)
readmission;
mean no. of
readmissions 1.7
(1-5)
ICU
days/visits
Re-operation
Blood transfusion
Medication use
Tests/Diagnosis
Other
'Office visits': 4.9
(1-20)
Duration of followup: 69.5 (14-347)
No Pancreatic
stump leak (No-PL)
44
Total: 5.2(1.7) [312 days]
Readmitted: 0
(0%)
-
Simons, 2009
Pancreaticoduodenectomy and Pancreatectomy (Mixed populations)
Behrman, 2008
All patients
169
Patients with
32
28.5
postoperative Intra-
underwent reexploration for
presumed splenic infarct but
required no further intervention.
-
-
-
-
-
-
-
21/ 32 patients had 1
procedure alone, but 11(34%)
-
-
-
interventional
radiology
drainage: 12
(55%); No.;
interventional
radiology drainage
per patient: 1.1 (05)
computed
tomographic
scans
Postoperatively:
4.6 (0-15)
Emergency room
visits: NR
visiting nurse
services for their
postoperative
care:3 (7%)
'Office visits': 1.6
(1-6)
Duration of followup: 16.0 (8-128)
Multiple drains: 7
Perioperative
27
Study
Belyaev, 2011
Kent, 2011
Comparison
group
abdominal sepsis
n
Hospital stay
(days)
ICU
days/visits
Patients with No
postoperative Intraabdominal sepsis
All patients
164
15.2
-
696
14 (1-158)
Patients who
developed clinically
significant POPF
Patients who did
not develop a
pancreatic leak
(control)
All patients
No readmission
within 30 days (all
resection types)
25
26 (15-100)
25
14 (8-38)
578
467
8
8 days (total
stay)
Re-operation
Blood transfusion
Medication use
Tests/Diagnosis
Other
required multiple procedures:
Percutaneous drainage (PD):
27
open operative drainage to
eradicate the septic focus: 10
Operative drainage (OD) after
failed Percutaneous drainage:
4
Additionally,
open surgical drainage to
eradicate the septic
focus needed for 4 of 21 (19%)
developing infection (abscess)
on or after postoperative day 7.
-
octreotide:30
(93.8)
-
-
-
Length of
stay: 1 (1111)
Length of
stay: 5 (192)
Length of
stay: 1 (1-5)
NR
-
-
-
Perioperative
octreotide:109
(66.5)
-
8 (32%)
-
-
-
-
2 (8%)
-
-
-
-
-
-
-
-
-
No. (%) with: any
complications: 217
(46.9)
Major
complications: 50
(10.8)
Pathway
deviation: 166
28
Study
Comparison
group
30-Day readmitted
patients (all
resection types)
n
111
Hospital stay
(days)
8 days initial stay
and
23 (21%) with
multiple
readmissions
within the first 30
days after the
original
discharge.
Readmission
stay: 7 days
Total days: 15
ICU
days/visits
-
Re-operation
-
Blood transfusion
-
Medication use
-
Tests/Diagnosis
-
Other
(35.9)
Clinically relevant
pancreatic fistula:
37 (8)
Delayed gastric
Emptying: 21 (4.5)
Wound infection:
55 (11.9)
Myocardial
Infarction: 9 (1.9)
Pneumonia: 28
(6.1)
Acute renal
failure: 7 (1.5)
No. (%) with: any
complications: 84
(76.4)
Major
complications: 34
(30.9)
Pathway
deviation: 65
(60.8)
Clinically relevant
pancreatic fistula:
40 (36.4)
Delayed gastric
Emptying: 13
(11.8)
Wound infection:
26 (23.6)
Myocardial
Infarction: 1 (0.9)
Pneumonia: 9
(8.2)
Acute renal
failure: 3 (2.7)
29
Study
Pratt, 2009
Comparison
group
All patients
‘No relevance’
(patients who either
lacked evidence of
fistula or
demonstrated
biochemical
evidence alone)
Evident fistula
n
Latent Fistula
20
Type I: subacute
latent pancreatic
fistula
6
Type II: acute latent
8
405
349
36
Hospital stay
(days)
NR
Initial: 8 (IQR 7–
8)
n(%) readmitted:
35 (10.0)
Total stay: 8
(IQR 7–9)
ICU
days/visits
13 (3.7%)
2 (6%)
Re-operation
Blood transfusion
Medication use
Tests/Diagnosis
Other
CT-guided percutaneous
drainage: NR
Surgical exploration: NR
45 (12.9)
Supplemental
parenteral
nutrition: 28 (8.0)
Antibiotics: 76
(21.8)
-
discharged to
Rehabilitation
facilities, n(%): 35
(10.1)
Initial: 9 (IQR 7–
15)
n(%) readmitted:
13 (36)
Total stay: 14
(IQR 8–20)
Initial: 10 (IQR
8–18)
n(%) readmitted:
12 (60)
Total stay: 20
(IQR 13–26)
Initial: 8
n(%) readmitted:
5
Total stay: 8
5 (25%)
CT-guided percutaneous
drainage: 9
Surgical exploration: 2
12 (33)
Supplemental
parenteral
nutrition: 9 (25)
Antibiotics: 25 (69)
discharged to
Rehabilitation
facilities, n(%): 12
(34)
1
CT-guided percutaneous
drainage: 7
Surgical exploration: 7
11 (55)
Supplemental
parenteral
nutrition: 8 (40)
Antibiotics: 15 (75)
discharged to
Rehabilitation
facilities, n(%): 6
(30)
1
CT-guided percutaneous
drainage: 5
Surgical exploration: 2
-
-
-
Initial: 8
3
CT-guided percutaneous
-
-
-
Time to removal of
intra-abdominal
drain: 7 (IQR 6–9)
presented to an
outpatient surgical
clinic on day 32
after surgery (18
days after hospital
discharge) with
copious fluid
emerging from her
drain, which had
been
placed during
surgery: 1
Time to removal of
30
Study
Hepatic resection
Breitenstein, 2010
†
Comparison
group
pancreatic fistula
n
Hospital stay
(days)
n(%) readmitted:
7
Total stay: 23
ICU
days/visits
Type III: critical
latent pancreatic
fistula
Re-operation
6
Initial: 19
n(%) readmitted:
0
Total stay:19
13 (3.7)
drainage: 1
Surgical exploration: 3
required reoperation: 1
(pancreaticojejunostomy
repair)
CT-guided percutaneous
drainage: 1
Surgical exploration: 2
required reoperation for
definitive management of
fistula: 2
All patients
615
11 (IQR 9-17)†
1 (IQR 0-2)†
-
no complications,
or Grade I or II
complications
grade III or IV
complications
Score 0-2 (low-risk
of postoperative
complications)
Score 3-5
(intermediate risk of
postoperative
complications)
Score 6-10 (high
risk of
postoperative
complications)
456
11 (IQR 9-13)†
1 (IQR 0-1)†
-
159
22(IQR 15-31)†
3 (IQR1-8)†
-
-
-
-
-
-
-
-
Blood transfusion
Medication use
Tests/Diagnosis
Other
intra-abdominal
drain: 7 (IQR 6–7)
-
-
-
Time to removal of
intra-abdominal
drain: 36 (IQR 18–
50)
2 (2-4) † §
(intraoperative)
2 (1-4) † §
(intraoperative)
-
-
-
-
-
-
-
-
-
-
3 (2-6) † §
(intraoperative)
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
Median (range), or Median (interquartile range) ‡Mean (sd) or mean (range) §Units for transfusions not reported, presumed to be ‘blood units’, per person.
Table A7: Costs associated with Urology surgery
31
Study
Comparison group
Radical prostatectomy
Bartsch, 2008
Guillonneau,
2003
Treiyer, 2009
Yu, 2012
All patients
With any
complications
Without
complications
†Where
n
Currency/
cost year†
Preoperative
Intraoperative
Postoperative
Indirect costs
Total hospital costs
[2013 US$]
-
-
-
-
-
-
-
11513
(prope
nsity
adjust
ed and
weight
ed)
NR
US $/NR
(2008)
-
-
-
-
-
-
-
-
-
-
-
-
-
Mean cost per patient
with any complication:
For a complicated
patient with a length of
stay <2 days duration:
US $10,267 [11,191]
For a complicated
patient with a length of
stay ≥2 days duration:
US $17,245 [18,797]
Mean cost per patient
with any complication:
For a complicated
patient with a length of
stay <2 days duration:
US $7,233 [7,883]
For a complicated
patient with a length of
stay ≥ 2 days duration:
US $9,240 [10,071]
NR
the cost year is not reported, the year of data collection (or end thereof for ranges) was used (provided in brackets)
32
Table A8: Resource use associated with Urology surgery
Study
Comparison
group
Radical prostatectomy
Bartsch, 2008
All patients
Guillonneau,
2003
N/n
148
Hospital stay
(days)
ICU
days
Re-operation
Blood
transfusion
Medication use
Tests/Diagnosis
Patients with
bacteriuria/UTI
66 (Cases)
Most patients
were
hospitalized for
10–14 days
after surgery
-
Patients without
bacteriuria/UTI
82
-
-
-
-
For 66 cases of bacteriuria/UTI in
48 patients:
The most often orally administered
antibiotics for bacteriuria/UTI in this
study were
trimethoprim/sulfamethoxazole
(44.6%), levofloxacin (29.8%), and
cefuroxime axetile (20.7%), while
cefotaxime, ciprofloxacin, and
piperacillin/tazobactam were
administered in single cases only.
-
All patients
NA
-
-
-
-
-
-
Patients with rectal
injury
13
For 9 patients
with an
uneventful
immediate
postoperative
course and
mean hospital
stay was 6.8
days
-
rectal injury
diagnosed
intraoperatively
and primary repair
was performed
laparoscopically:
11/13
Exploratory
laparotomy for
-
-
-
Other
-
-
-
-
-
-
-
-
-
-
Time to
removal of
indwelling
catheter: 17
days
-
Time to
removal of
indwelling
catheter:15
days
Patients with
failed primary
repair (2) or
delayed
diagnosis of the
rectal
injury (2) had a
urethral
catheter for 12,
33
Study
Comparison
group
N/n
Hospital stay
(days)
ICU
days
Re-operation
Blood
transfusion
Medication use
Tests/Diagnosis
patients, who had
undergone closure
of the 1-layer
rectal injury
intraop: 2/13
Patients with
failed primary
repair (2) or
delayed
diagnosis of the
rectal
injury (2) had
hospital stay of
7, 16, 21 and
27 days,
respectively.
Other
13, 15 and 120
days.
8.6 days
urethral
catheter (range
5 to 10) for 9
patients with
uneventful
immediate
postoperative
course
Colostomy: 3/13
perineal repair
required for
rectourethral
fistula: 1
indwelling
bladder
drainage for 3
months: 1/13
(for
rectourethral
fistula
formation)
Treiyer, 2009
Patients with
Persistent
symptomatic pelvic
lymphoceles after
PCD
15
-
-
For patients with
Persistent
symptomatic
pelvic
lymphoceles after
PCD (n=15):
percutaneous
catheter drainage
and sclerotherapy:
7 (46.7)
Laparoscopic
marsupialization of
pelvic
lymphoceles after
a failed combined
-
-
-
-
34
Study
Yu, 2012
Comparison
group
All patients
Patients with
complications
Patients without
complications
N/n
Hospital stay
(days)
ICU
days
Re-operation
Blood
transfusion
Medication use
Tests/Diagnosis
Other
2348 after
incorporating
NIS survey
weights
NR
1.7 (3.0)
-
PCDsclerotherapy: 3
(20.0)
Laparoscopic
marsupialization of
pelvic
lymphoceles
without using
sclerotherapy: 4
(26.7)
Open laparotomy:
1 (6.6)
-
-
-
-
-
-
-
No. of patients
discharged
home,
n(%):94.9%
-
NR
-
-
-
-
-
-
-
-
-
-
Table A9: Costs associated with gynaecological surgery
Study
Hysterectomy
Aaronson 2011
Comparison group
All patients
Patients without
non-infectious
urethral related
complication
n
96,386
96,355
Currency/
cost year†
Preoperative
Intraoperative
Postoperative
Indirect costs
US $/NR
(2007)
-
-
-
-
Total hospital costs
[2013 US$]
-
35
Coello 2005
Duong 2009
Gunnarsson
2009
Rotermann 2004
-
-
-
-
-
-
-
-
168 SSI
-
-
-
-
patients with
superficial incisional
SSI
Patients with either
Deep incisional or
organ/space SSI
Patients with VVF
Patients without
VVF
Patients with
nosocomial
infections post
laparoscopic
hysterectomy
134 SSI
-
-
-
-
34 SSI
-
-
-
-
4
30
-
-
-
-
4,783
US $/NR
(2006)
-
-
-
-
All patients receiving
hysterectomy
Uninfected patients
Infected patients
159,644
$ Canada/
Alberta:
2000/01;
Ontario:
1999/2000
-
-
-
-
-
-
-
-
Patients with noninfectious urethral
related complication
patients without
Surgical site
infections
patients with SSI (all
SSI types)
31
NR
156,390
3,254
UK £/2003
-
£959 [2001] additional
cost per patient
compared to no SSI
£814 [1698] additional
cost per patient
compared to no SSI
£1947 [4062] additional
cost per patient
compared to no SSI
Patients with nosocomial
infections post
laparoscopic
hysterectomy increased
their hospital costs by
an average of $4528
[5297]
Total cost for
readmissions ranged
from $4,406 - $5,088
[5,301 – 6,122].
Estimated to have an
annual cost due to
infection readmissions of
$2.26 to $2.61 million
[2.71 – 3.14].
Mixed population (Hysterectomy with other gynaecological procedures)
36
De Lissovoy
2009
†Where
-
-
-
-
268,733
-
-
-
-
Mean total hospital cost
per patient of $5457
[6,908]
With surgical site
infection: from
database
159
-
-
-
-
Mean total hospital cost
per patients with a
surgical site infection
was $19,425 [24,591]
which was $13,968
[17,683] greater than a
patient infection-free.
With surgical site
infection: Projected
national impact
772
-
-
-
-
All Obstetric and
gynaecologic
patients
Without surgical site
infection: from
database
269,041
$ US/NR
(2005)
the cost year is not reported, the year of data collection (or end thereof for ranges) was used (provided in brackets)
Table A10: Resource use associated with gynaecological surgery
Study
Hysterectomy
Aaronson 2011
Coello 2005
Comparison group
All patients
Patients without
non-infectious
urethral related
complication
Patients with noninfectious urethral
related complication
All patients
N/n
Hospital stay
(days)
ICU days
Re-operation
Blood transfusion
Medication use
Tests/ Diagnosis
Other
96,386
96,355
2.6
-
-
-
-
-
-
31
4.3
-
-
-
-
-
-
6789
(operations
-
-
-
-
-
-
-
37
Study
Comparison group
N/n
Hospital stay
(days)
ICU days
Re-operation
Blood transfusion
Medication use
Tests/ Diagnosis
Other
not
patients)
patients with SSI
(all SSI types)
patients with
superficial incisional
SSI
Patients with either
Deep incisional or
organ/space SSI
Duong 2009
Gunnarsson
2009
3.3 (2.7–4.0)
additional
hospital days
compared to no
SSI
2.8 (2.2–3.5)
additional
hospital days
compared to no
SSI
6.7 (4.7–8.9)
additional
hospital days
compared to no
SSI
8.5 (SE: 2.9)
days
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
25% patients
-
-
Mean operating
time was 376
(SE: 126) min
Indwelling
catheter use
10.5 (SE: 3.5)
days
-mean operating
time 209 (SE:
18) min
-indwelling
catheter use 8.5
(SE: 0.4) days
-
-
Patients with VVF
4
Patients without
VVF
30
3.9 (SE: 0.6)
days
-
-
30% patients
-
-
Patients with
nosocomial
infections post
laparoscopic
hysterectomy
4783
Patients with
nosocomial
infections post
laparoscopic
hysterectomy
increased their
length of
-
-
-
-
-
-
38
Study
Rotermann
2004
Comparison group
N/n
Uninfected patients
156,390
Infected patients
3254
Hospital stay
(days)
hospital stay by
average of 2.52
days
4.2 days
(includes
hospital stay
and
readmissions)
10.6 days
(includes initial
stay and
readmissions)
ICU days
Re-operation
Blood transfusion
Medication use
Tests/ Diagnosis
Other
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
Mixed population (Hysterectomy with other gynaecological procedures)
De Lissovoy
All Obstetric and
269,041
2009
gynaecologic
patients
Without surgical site 159
4.8
infection: from
(matched
database
pts with no
infection)
With surgical site
159
10.8
infection: from
database
39
Table A11: Costs associated with thoracic surgery
Study
Comparison group
Lobectomy/bilobectomy
Handy, Jr, 2011
Uncomplicated
(lobectomy)
Liberman, 2010
Okereke, 2005
Seely, 2010
n
222
Currency/
cost year†
US $/NR
(2007)
Preoperative
Intraoperative
Postoperative
Indirect costs
Total hospital costs
[2013 US$]
-
-
-
-

-
-
-
-

Complications or
Death (lobectomy)
46
Overall study
population
Prolonged air leak
Control (700
consecutive
patients)
All patients
Air leak
No air leak
Lobectomy patients
Lobectomy patients
with Grade I
complications
Lobectomy patients
with Grade II
complications
Lobectomy patients
with Grade IIIa
complications
Lobectomy patients
with Grade IIIb
complications
Lobectomy patients
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
Total hospital costs
(initial admission);
Mean total hospital
cost per patient:
$18,449 [21,031]
Total hospital costs
(initial admission);
Mean total hospital
cost per patient:
$39,250 [44,745]
40
Study
Stolz, 2005
Varela, 2005
Comparison group
with Grade IVa
complications
Lobectomy patients
with Grade IVb
complications
All patients
Non Prolonged air
leak
Prolonged air leak
All patients
Non Prolonged air
leak
Prolonged air leak
n
Currency/
cost year†
Preoperative
Intraoperative
Postoperative
Indirect costs
Total hospital costs
[2013 US$]
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
21
Euro/NR
(2003)
-
-

-

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
Mixed pulmonary resection type populations
Antanavicius,
All patients
2005
No Air Leak Group:
Water seal use
No Air Leak Group:
Suction use
Air Leak Group:
Water seal use
Air Leak Group:
Suction use
Bardell, 2003
All patients
91
Pneumothorax any
37
Medical staff; Total
excess pharmacy costs
for cohort: €712.43
Overall Hospital
costs (initial surgery
+ readmissions);
Total estimated PAL
costs excess for
cohort: €39437
[64,701] (Total cost
LOS excess + Total
excess pharmacy
costs for PAL
patients, nb costs
for whole cohort of
21 cases, not per
patient)
41
Study
Dulu, 2006
Comparison group
time on CXR
No Pneumothorax
any time on CXR
Pneumothorax on
postoperative CXR
No Pneumothorax
on postoperative
CXR
Subcutaneous
emphysema
No Subcutaneous
emphysema
Atelectasis
No Atelectasis
Reoperation
No Reoperation
Prolonged air leak
No Prolonged air
leak
All patients
Patients who
acquired ALI and/or
ARDS requiring
invasive mechanical
ventilation and ICU
admission
Patients who No ALI
and/or ARDS
requiring mechanical
ventilation
Patients with
ALI/ARDS and ICU
stay Alive at
Hospital Discharge
Patients with
ALI/ARDS and ICU
n
Currency/
cost year†
Preoperative
Intraoperative
Postoperative
Indirect costs
Total hospital costs
[2013 US$]
54
-
-
-
-
-
-
25
-
-
-
-
-
-
66
-
-
-
-
-
-
41
-
-
-
-
-
-
50
-
-
-
-
-
-
20
71
6
85
27
64
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
42
Study
Ghosh, 2004
Ishikawa, 2012
Pilling, 2004
Comparison group
stay Dead at
Hospital Discharge
All patients
(lobectomies,
pneumonectomies
and
oesophagectomies
All Patients
managed in the high
dependency unit
(HDU)
Lung resection
patients
Esophagectomy
patients
All patients
Patients with Acute
kidney injury
diagnosed within 72
hours
postoperatively
Patients without
Acute kidney injury
ICU admitted
patients after
pulmonary resection
n
Currency/
cost year†
Preoperative
Intraoperative
Postoperative
Indirect costs
Total hospital costs
[2013 US$]
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
1129
67
-
-
-
-
-
-
1062
-
-
-
-
-
-
28
US $/NR
(2001)
-
-
-
-
Overall Hospital costs
(initial surgery +
readmissions): $6,975
(3100–186,775) [9,416
(4,185–252,146)] (ICU
and hospital stay)
Overall Hospital costs
(initial surgery +
readmissions): $6,975
(3100–56,575) [9,416
(4,185–76,376)] (ICU
and hospital stay)
Overall Hospital costs
ICU admitted
patients after
pulmonary
resection: Hospital
Survivors
15
-
-
-
-
ICU admitted
13
-
-
-
-
43
Study
Comparison group
n
Currency/
cost year†
Preoperative
Intraoperative
Postoperative
Indirect costs
patients after
pulmonary
resection: Hospital
Deaths
Roselli, 2005
Seely, 2010
Total hospital costs
[2013 US$]
(initial surgery +
readmissions): $19,375
(3100–186,755) [26,156
(4,185–252,146)] (ICU
and hospital stay)
Total hospital costs
(initial admission), Cost
ratio: 1.8 (direct technical
costs of postoperative
care were higher for the
AF group)
-
All patients
Postoperative Atrial
fibrillation
(propensity-matched
patients)
91
-
-
-
-
-
No postoperative
Atrial fibrillation
(propensity-matched
patients)
Atrial fibrillation as a
SOLITARY
complication
(propensity-matched
patients)
91
-
-
-
-
-
74
-
-
-
-
-
No postoperative
Atrial fibrillation
(propensity-matched
patients)
Pulmonary resection
patients with air leak
Pulmonary resection
patients with atrial
fibrillation
Pulmonary resection
patients with
Pneumothorax
Pulmonary resection
75
-
-
-
-
-
Total hospital costs
(initial admission), Cost
ratio: 1.5 (costs of
postoperative care were
higher for the group with
AF as a sole
complication)
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
44
Study
Comparison group
patients with MI
Pulmonary resection
patients with
Pneumonia
†Where
n
-
Currency/
cost year†
-
Preoperative
-
Intraoperative
-
Postoperative
-
Indirect costs
-
Total hospital costs
[2013 US$]
-
the cost year is not reported, the year of data collection (or end thereof for ranges) was used (provided in brackets)
45
Table A12: Resource use associated with thoracic surgery
Study
Comparison group
Lobectomy/bilobectomy
Handy, Jr,
Uncomplicated
2011
(lobectomy)
Complications or
Death (lobectomy)
Overall study
Liberman,
population
2010
N/n
Hospital
stay (days)
Re-operation
Blood
transfusion
Medication use
Tests/
Diagnosis
Other
222
Mean: 6
-
-
-
-
-
-
46
Mean: 12
-
-
-
-
-
-
778

-
-
-
-
-


Prolonged air leak
ICU
days
78


Mean
(SD): 7.8
(15.9)
Median
(range):
5.0 (2373)
Mean
(SD):
14.2
(13.3)
Median
(range):
12.0 (6–
104)

-

Reoperation, No
(%) patients reoperated:
o
wedge
resection: 1
(1.3%)
o
Muscle flap:
1 (1.3%)
-
-
-




Okereke, 2005
Seely, 2010
Time to removal of drains
(chest), days, mean (SD):
3.9 (3.9)
Time to removal of drains
(chest), days (median,
range): 3.0 (0-57)
No. of patients with
readmissions, n (%): 1
(1.3%) (for
pneumothorax)
Time to removal of drains
(chest), days, mean (SD):
11.5 (4.4)
Time to removal of drains
(chest), days (median,
range): 11.0 (6-27)
Non-pharmacological
management:
o
pleurodesis for PAL:
41 (52.6%)
o
discharge home with
Heimlich valve: 4
(Total)
o
placement of a
chest tube: 1(1.3%)
Control (700
consecutive patients)
All patients
Air leak
NR
-
-
-
-
-
-
-
319
82
-
-
-
-
-
-
No air leak
Lobectomy patients
with Grade I
complications
82
-
Median
(range): 5.5
(5 to 11)
-
-
-
-
-
P value vs comparator, length
of stay > 5 days: P=0.02
P value vs comparator
(analysis of variance):
P<0.0001
46
Study
Stolz, 2005
Varela, 2005
Comparison group
N/n
Hospital
stay (days)
ICU
days
Re-operation
Blood
transfusion
Medication use
Tests/
Diagnosis
Other
Lobectomy patients
with Grade II
complications
Lobectomy patients
with Grade IIIa
complications
Lobectomy patients
with Grade IIIb
complications
Lobectomy patients
with Grade IVa
complications
Lobectomy patients
with Grade IVb
complications
All patients
Non Prolonged air
leak
-
Median
(range): 8 (3
to 42)
-
-
-
-
-
-
-
Median
(range: 8 (3
to 23)
-
-
-
-
-
-
-
Median
(range): 7.5
(5 to 14),
-
-
-
-
-
-
-
Median
(range): 31
(19 to 114 )
-
-
-
-
-
-
-
Median: 43
-
-
-
-
-
-
134
121
Mean (SD):
7.9 (1.44)
-
-
-
-
-
Prolonged air leak
13
-
-
-
-
-
All patients
238
Mean (SD):
13.7(3.92)
Mean (SD):
6.3 (3.3)
P value vs comparator, length
of stay (initial admission):
P<0.01
-
-
-
-
-
-

Non Prolonged air
leak
215
-
-
-
-
-
-


Prolonged air leak
23
-
-
-
-
-
-



Total stay (initial
+readmissions), median
(range: 5 (3-34)
Total stay (initial
+readmissions), median
(range: 5 (3-34)
P value vs comparator for
total stay: P<0.001
No. of patients with
readmissions, n (%): 3
(13%)
Readmissions, length of
stay (days, mean SD): 2
and 14 days
(pneumothorax cases),
and 49 days (empyema
patient)
Total stay (initial
+readmissions), median
(range: 10 (6-22)
Mixed pulmonary resection type populations
47
Study
Antanavicius,
2005
Comparison group
All patients
No Air Leak Group:
Water seal use
N/n
109
32
Hospital
stay (days)
Mean (SD):
5.13 (0.61)
ICU
days
-
Re-operation
-
Blood
transfusion
-
Medication use
-
Tests/
Diagnosis
-
Other




No Air Leak Group:
Suction use
46
Mean (SD):
6.74 (0.5)
-
-
-
-
-

Air Leak Group:
Water seal use
7
Mean (SD):
6.57 (0.69)
-
-
-
-
-





Air Leak Group:
24
Mean (SD):
-
-
-
-
-

P value versus
comparator (length of
stay, water seal vs
suction, no air-leak
patients): P<0.04
Time to removal of drains
(chest), days, mean (SD):
3.19 (0.24)
Time to chest tube
conversion to water seal,
days, mean (SD): 2.65
(1.09)
Time to removal of chest
tube, P value vs
comparator (water seal vs
suction, no air-leak
patients time to drain
removal): P=0.007
Time to removal of drains
(chest), days, mean (SD):
4.52 (0.4)
P value versus
comparator (length of
stay, water seal vs
suction, air-leak patients):
P<0.05
Time to removal of drains
(chest), days, mean (SD):
5.0 (0.49)
Time to chest tube
conversion to water seal,
days, mean (SD):
Time to removal of chest
tube, P value vs
comparator (water seal vs
suction, air-leak patients
time to drain removal):
P=0.001
Treatment; discharged
with indwelling chest
tubes with Heimlich valve
management: 3 (includes
suction and water seal
groups)
Time to removal of drains
48
Study
Comparison group
N/n
Hospital
stay (days)
ICU
days
Re-operation
Blood
transfusion
Medication use
Tests/
Diagnosis
Other
8.96 (0.86)
Suction use



Bardell, 2003
Mean (SD):
6.4
Mean (SD):
7.5
-
-
-
-
-
-
-
-
-
-
-

54
Mean (SD):
5.8
-
-
-
-
-
-
25
Mean (SD):
7.8
-
-
-
-
-

No Pneumothorax on
postoperative CXR
Subcutaneous
emphysema
66
Mean (SD):
5.9
-
-
-
-
-
-
41
Mean (SD):
7.3
-
-
-
-
-

No Subcutaneous
emphysema
Atelectasis
50
Mean (SD):
5.8
-
-
-
-
-
-
20
Mean (SD):
6.9
-
-
-
-
-

All patients
91
Pneumothorax any
time on CXR
37
No Pneumothorax
any time on CXR
Pneumothorax on
postoperative CXR
(chest), days, mean (SD):
6.35 (0.65)
Time to chest tube
conversion to water seal,
days, mean (SD):
4.43(2.17)
Time to chest tube
conversion to water seal,
days, mean (SD):
4.43(2.17)
Treatment; discharged
with indwelling chest
tubes with Heimlich valve
management: 3 (includes
suction and water seal
groups)
P value versus
comparator (length of
stay, water seal vs
suction, air-leak patients):
P 0.06
P value versus
comparator (length of
stay, water seal vs
suction, air-leak patients):
P=0.049
P value versus
comparator (length of
stay, water seal vs
suction, air-leak patients):
P=0.08
P value versus
comparator (length of
stay, water seal vs
suction, air-leak patients):
P=0.66
49
Study
Dulu, 2006
Ghosh, 2004
Comparison group
N/n
Hospital
stay (days)
ICU
days
Re-operation
Blood
transfusion
Medication use
Tests/
Diagnosis
Other
Mean (SD):
6.3
Mean (SD):
16.8
-
-
-
-
-
-
-
-
-
-
-

Mean (SD):
5.7
Mean (SD):
9.4
-
-
-
-
-
-
-
-
-
-
-

-
-
-
-
-
-
50
Mean (SD):
5.2
Median
(range): 26.6
(6-93)
Median
(range):
10 (2-43)
-
-

-
-
-
-
-
-
-
-
-
-
30
Median
(range): 24.5
(10-58)
Median
(range):
9 (2-34)
-
-

-
-
20
Median
(range): 28.5
(6-93)
-
-

-
-
-
-
Median
(range):
15.5 (343)
-
-
-
-
-
-
No Atelectasis
71
Reoperation
6
No Reoperation
85
Prolonged air leak
27
No Prolonged air leak
64
All patients
Patients who acquired
ALI and/or ARDS
requiring invasive
mechanical ventilation
and ICU admission
Patients who No ALI
and/or ARDS
requiring mechanical
ventilation
Patients with
ALI/ARDS and ICU
stay Alive at Hospital
Discharge
Patients with
ALI/ARDS and ICU
stay Dead at Hospital
Discharge
All patients
(lobectomies,
pneumonectomies
and

Corticosteroids: 39
(78%)
Corticosteroids: 25
(64%)
P value versus
comparator
(Pharmacological
management
administered; for
corticosteroid use):
0.31
Corticosteroids: 14
(36)
P value versus
comparator (length of
stay, water seal vs
suction, air-leak patients):
P<0.001
P value versus
comparator (length of
stay, water seal vs
suction, air-leak patients):
P<0.001
50
Study
Comparison group
oesophagectomies)
All Patients managed
in the high
dependency unit
(HDU)
Ishikawa, 2012
Lung resection
patients
Esophagectomy
patients
All patients
Patients with Acute
kidney injury
diagnosed within 72
hours postoperatively
N/n
318
Hospital
stay (days)
Mean (SD):
21.8 hours
ICU
days
-
Re-operation
Blood
transfusion
No of patients with
additional procedures
OR re-exploration, n
(%) and reasons:
initially monitored in
the recovery unit and
then re-explored for
bleeding: 2
-
Medication use
-
Tests/
Diagnosis
-
Other



277
Mean (SD):
7.3
-
-
-
-
-
-
50
Mean (SD):
9.1
-
-
-
-
-
-
1129
Median
(range): 8
(IQR 6-11)
-
-
No (%)
patients
given:
Received
Red blood
cells: 20 (2)
Received
fresh frozen
plasma: 2
(0.2)
Received
platelets: 2
(0.2)
Pharmacological
management, No (%)
patients given: Adjuvant
epidural: 701 (62)
-

No (%)
patients
given:
Received
Red blood
cells: 5 (7)
Received
fresh frozen
plasma:0
Received
Pharmacological
management, No (%)
patients given: Adjuvant
epidural: 50 (75)
67
Median
(range): 10
(IQR 7-14)
-
-



-


No. of patients with
readmissions, n (%): 8.4
No. of patients with ICU
visits, n (%): 6.1
Non Pharmacological
management
administered, No (%)
patients given mechanical
ventilation or needed
more invasive monitoring
with inotropes in ITU: 6
P value vs comparator,
length of stay (initial
admission): P<0.001
Operating room time,
median (IQR): 109 (63)
P value vs comparator
(operation duration):
P<0.001
Non Pharmacological
management, No (%)
patients given:
o
Received
hydroxyethyl starch:
74 (7)
o
Mechanical
ventilation:47 (4)
o
Reintubation: 28 (2)
Operating room time,
median (IQR): 143 (73)
Non Pharmacological
management, No (%)
patients given:
o
Received
hydroxyethyl starch:
13 (19)
o
Mechanical
ventilation:10 (15)
o
Reintubation: 8 (12)
51
Study
Pilling, 2004
Comparison group
N/n
Patients without Acute
kidney injury
1062
ICU admitted patients
after pulmonary
resection
28
Hospital
stay (days)
ICU
days
Median
(range): 8
(IQR 5-10)
-
Median
(range): 21
(5-91)
Median
(range):
3 (1-80)
Re-operation
-
No of patients with
additional procedures
OR re-exploration, n
(%) and reasons: 7
(25): 4 patients
underwent
thoracotomy (2
patients for control of
haemorrhage, 1 patient
for repair of a dehisced
diaphragmatic patch,
and 1 patient for
decortication of a
postoperative
empyema). 3 patients
required laparotomy
(for control of upper
gastrointestinal
haemorrhage in 2
patients, and for repair
of strangulated inguinal
hernia in 1 patient).
Blood
transfusion
platelets: 1
(2)
No (%)
patients
given:
Received
Red blood
cells: 15 (1)
Received
fresh frozen
plasma: 2
(0.2)
Received
platelets: 1
(0.1)
-
Medication use
Pharmacological
management, No (%)
patients given: Adjuvant
epidural: 651 (61)

Pharmacological
management, No (%)
patients given:
o
Inotropic support
(either adrenaline,
noradrenaline, or
high-dose
dopamine
infusion): 15
(54%)
o
Continuous
infusion of
diuretics and lowdose dopamine
for Renal failure:
11 (39%)
o
Required
intravenous
antibiotics for
clinically
significant
methicillinresistant
Staphylococcus
aureus (MRSA)
infection: 14
(50%)
Tests/
Diagnosis
-
Other








Operating room time,
median (IQR): 107 (62)
Non Pharmacological
management, No (%)
patients given:
o
Received
hydroxyethyl starch:
74 (7)
o
Mechanical
ventilation:47 (4)
o
Reintubation: 28 (2)
Length of stay of pts
discharged from ICU back
to ward, median (range);
3 days (1-35)
P value versus
comparator (length of
stay): p=0.6
Total stay (initial
+readmissions), median
(range): 23 days (11-90
days).
Length of stay in high
dependency unit prior to
ICU admission, median
(range): 5 (1-60)
P value versus
comparator (length of stay
in ICU): p=0.08
Non Pharmacological
management, No (%)
patients given:
o
Mechanical
ventilation after ICU
admission: 17 (16%)
o
Use of
bronchoscopy and
insertion of
minitracheostomy: 2
o
Invasively monitored
52
Study
Comparison group
N/n
Hospital
stay (days)
ICU
days
Re-operation
Blood
transfusion
Medication use
Tests/
Diagnosis
Other
without inotropic
support: 13 (46%)
Roselli, 2005
Seely, 2010
ICU admitted patients
after pulmonary
resection: Hospital
Survivors
ICU admitted patients
after pulmonary
resection: Hospital
Deaths
All patients
Postoperative Atrial
fibrillation (propensitymatched patients)
15
Median
(range): 22
(11-91)
Median
(range):
3 (1-35)
-
-
-
-
-
13
Median
(range): 17
(5-91)
Median
(range):
9 (1-80)
-
-
-
-
-
91
Median
(range): 8
(15th and
85th
percentiles 5
and 14 days)
-
-
-
-
-

No postoperative
Atrial fibrillation
(propensity-matched
patients)
91
-
-
-
-
-
-
Atrial fibrillation as a
SOLITARY
complication
(propensity-matched
patients)
No postoperative
Atrial fibrillation
(propensity-matched
patients)
Pulmonary resection
patients with air leak
75
Median
(range): 5
(15th and
85th
percentiles 4
and 10 days)
Median
(range): 7
-
-
-
-
-

P value versus
comparator (length of
stay): CL 5-9 days, P <
0.0001 (68% Confidence
limits used)
75
Median
(range): 5
-
-
-
-
-

P value versus
comparator (length of
stay): CL 4-8 days (68%
Confidence limits used)
-
-
-
-
-
-
-

Length of stay in hospital
(initial admission), No of
patients with prolonged
length of stay, n(%): 12
(29)
Length of stay in hospital
(readmissions), No. of
patients with
readmissions, n(%):7

P value versus
comparator (length of
stay): P<0.0001
53
Study
Comparison group
Pulmonary resection
patients with atrial
fibrillation
N/n
41
Hospital
stay (days)
-
ICU
days
-
Re-operation
-
Blood
transfusion
-
Medication use
-
Tests/
Diagnosis
-
Other


Pulmonary resection
patients with
Pneumothorax
41
-
-
-
-
-
-


Pulmonary resection
patients with MI
41
-
-
-
-
-
-


Pulmonary resection
patients with
Pneumonia
41
-
-
-
-
-
-


(17)
Length of stay in hospital
(initial admission), No of
patients with prolonged
length of stay, n(%): 3 (7)
Length of stay in hospital
(readmissions), No. of
patients with
readmissions, n(%): 1(2)
Length of stay in hospital
(initial admission), No of
patients with prolonged
length of stay, n(%): 1 (2)
Length of stay in hospital
(readmissions), No. of
patients with
readmissions, n(%): 0 (0)
Length of stay in hospital
(initial admission), No of
patients with prolonged
length of stay, n(%):1 (2)
Length of stay in hospital
(readmissions), No. of
patients with
readmissions, n(%): 0 (0)
Length of stay in hospital
(initial admission), No of
patients with prolonged
length of stay, n(%): 2 (5)
Length of stay in hospital
(readmissions), No. of
patients with
readmissions, n(%):0 (0)
54