title: Impact of postoperative complications on clinical and economic consequences in pancreatic surgery.
abstract: OBJECTIVE
  Patients who develop complications consume a disproportionately large share of available resources in surgery; therefore the attention of healthcare funders focuses on the economic impact of complications. The main objective of this work was to assess the clinical and economic impact of postoperative complications in pancreatic surgery, and furthermore to assess risk factors for increased costs.
  
  
  METHODS
  In all, 161 consecutive patients underwent pancreatic resection. The costs of the treatment were determined and analyzed.
  
  
  RESULTS
  The overall morbidity rate was 53.4%, and the in-hospital mortality rate was 3.7%. The median of costs for all patients without complication was 3,963 Euro, whereas the median of costs for patients with at least one complication was significantly increased at 10,670 Euro (P < 0.001). In multivariate analysis American Society of Anesthesiologists ≥ 3 (P = 0.006), multivisceral resection (P < 0.001) and any complication (P < 0.001) were independently associated with increased costs.
  
  
  CONCLUSIONS
  Postoperative complications are associated with an increase in mortality, length of hospital stay, and hospital costs. The treatment costs increase with the severity of the postoperative complications. Those factors that are known to increase the treatment costs in pancreatic resection should be considered when planning patients for surgery.
authors.affiliation: Department of Surgery, Faculty of Medicine and University Hospital Hradec Králové, Hradec Králové, Czech Republic.
authors.forename: Filip
authors.initials: F
authors.lastname: Čečka
authors.affiliation: Department of Surgery, Faculty of Medicine and University Hospital Hradec Králové, Hradec Králové, Czech Republic.
authors.forename: Bohumil
authors.initials: B
authors.lastname: Jon
authors.affiliation: Department of Biophysics and Statistics, Faculty of Medicine Hradec Králové, Charles University in Prague, Hradec Králové, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Čermáková
authors.affiliation: Department of Surgery, Faculty of Medicine and University Hospital Hradec Králové, Hradec Králové, Czech Republic.; Department of Field Surgery, Military Health Science Faculty, Hradec Králové, Defence University Brno, Hradec Králové, Czech Republic.
authors.forename: Zdeněk
authors.initials: Z
authors.lastname: Šubrt
authors.affiliation: Department of Surgery, Faculty of Medicine and University Hospital Hradec Králové, Hradec Králové, Czech Republic.
authors.forename: Alexander
authors.initials: A
authors.lastname: Ferko
keywords: Pancreatectomy; Pancreatic fistula; Pancreaticoduodenectomy; Postoperative complications