title: Hospital cost-analysis of complications after major abdominal surgery.
abstract: BACKGROUND
  Complications after major abdominal surgery (MAS) are associated with increased morbidity and mortality. Rising costs in health care are of increasing interest and a major factor affecting hospital costs are postoperative complications. In this study, the costs associated with complications are assessed.
  
  
  METHODS
  Retrospective cohort study of 399 consecutive patients that underwent MAS. Analysis of total costs for hospital stay, complications and treatment was performed, including bootstrapping; allowing for subtraction of data with 95% confidence intervals.
  
  
  RESULTS
  For a single patient who underwent MAS the average costs, adjusted for ASA-classification and surgery type, adds up to EUR 8,584.81 (95% CI EUR 8,332.51 - EUR 8,860.81) in patients without complications. EUR 15,412.96 (95% CI EUR 14,250.22 - EUR 16,708.82) after minor complications, and EUR 29,198.23 (95% CI EUR 27,187.13 - EUR 31,295.78) after major complications (p < 0.001).
  
  
  CONCLUSIONS
  The results provide an insight into the scope of hospital costs associated with complications. Major complications occur in 20% of patients undergoing MAS and account for 50% of the total costs of care. Implementation of a protocol aimed at early diagnosis and treatment of complications might lead to a decrease in morbidity and mortality, but also prove to be cost effective.
authors: Department of Gastrointestinal Surgery, VU Medical Centre Amsterdam, The Netherlands.
authors: Jennifer
authors: J
authors: Straatman
authors: Miguel A
authors: MA
authors: Cuesta
authors: Elly S M
authors: ES
authors: de Lange-de Klerk
authors: Donald L
authors: DL
authors: van der Peet
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D002017:Budgets; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011183:Postoperative Complications / Q000191:economics* / Q000628:therapy; D012189:Retrospective Studies; D013503:Surgery Department, Hospital / Q000191:economics* / Q000706:statistics & numerical data