Surgical Cost of Care in Crohn’s Disease

• Authors: Deborah S. Keller , Jeffry Katz , Sharon L. Stein , Conor P. Delaney
• Languages of publication: EN

Abstracts

EN

The aim of the studywas to evaluate the cost of surgical care and short-term outcomes of Crohn’s disease(CD) in the era of laparoscopy and biologic therapy. Material and methods. Review of a prospective database identifiedCD patients that underwent surgical management. Patients were stratified into laparoscopic, open, and converted approaches. Main outcome measures were short-term patient outcomes and cost of care by approach. Results. 92 patients were analyzed- 63.1% laparoscopic, 32.6% open, 4.3% converted. The majority was elective (100% converted, 94.8% laparoscopic, 90% open) and segmental resections (75% converted, 70.7% laparoscopic, 43.3% open). Operative times were similar between laparoscopic and open (152 minutes and 138 minutes, respectively). More open patients required ICU care (20% versus 12.1% laparoscopic and 0% converted). The median LOS was 3 (1-25) days laparoscopic, 4 (1-29) open and 4 (3-8) converted. The laparoscopic complication rate was 15.5%, readmission rate 12.1%, and reoperation rate 8.6%. The mean total hospital cost was $9,702 laparoscopic, $10,782 open, and $13,293 for converted cases (US Dollars). Conclusions. Laparoscopy is appropriate for most CD cases. When necessary to combine with open surgery, this results in efficient and effective patient outcomes and healthcare utilization. These results are important when weighing the cost of ongoing medical therapy versus surgical intervention.

Keywords

EN

Crohn’s disease; cost of treatment; surgical management; biologic therapy

• Journal: Polish Journal of Surgery
• Year: 2013
• Volume: 85
• Issue: 9
• Pages: 511-516

Dates

published

1 - 09 - 2013

online

15 - 10 - 2013

Contributors

author

Deborah S. Keller

• Division of Colorectal Surgery, Department of Surgery, University Hospitals-Case Medical Center, Cleveland, Ohio

author

Jeffry Katz

• Division of Gastroenterology, Department of Medicine, University Hospitals-Case Medical Center, Cleveland, Ohio

author

Sharon L. Stein

• Division of Colorectal Surgery, Department of Surgery, University Hospitals-Case Medical Center, Cleveland, Ohio

author

Conor P. Delaney

• Division of Colorectal Surgery, Department of Surgery, University Hospitals-Case Medical Center, Cleveland, Ohio,

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Identifiers

DOI

10.2478/pjs-2013-0079