Linnemann Ralph J A, Kooijman Bob J L, van der Hilst Christian S, Sprakel Joost, Buis Carlijn I, Kruijff Schelto, Klaase Joost M
Department of Hepato-Pancreato-Billiary Surgery and Liver Transplantation, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
Department of Strategic Analytics, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
Cancers (Basel). 2021 Dec 14;13(24):6271. doi: 10.3390/cancers13246271.
BACKGROUND/OBJECTIVES: Complications after pancreatoduodenectomy (PD) lead to unplanned readmissions (UR), with a two- to threefold increase in admission costs. In this study, we aimed to create an understanding of the costs of complications and UR in this patient group. Furthermore, we aimed to generate a detailed cost overview that can be used to build a theoretical model to calculate the cost efficacy for prehabilitation.
A retrospective cohort analysis was performed using the Dutch Pancreatic Cancer Audit (DPCA) database of patients who underwent a PD at our institute between 2013 and 2017. The total costs of the index hospital admission and UR related to the PD were collected.
Of the 160 patients; 35 patients (22%) had an uncomplicated course; 87 patients (54%) had minor complications, and 38 patients (24%) had severe complications. Median costs for an uncomplicated course were EUR 25.682, and for a complicated course, EUR 32.958 ( = 0.001). The median costs for minor complications were EUR 30.316, and for major complications, EUR 42.664 ( = 0.001). Costs were related to the Comprehensive Complication Index (CCI). The median costs of patients with one or more UR were EUR 41.199.
Complications after PD led to a EUR 4.634-EUR 16.982 (18-66%) increase in hospital costs. A UR led to a cost increase of EUR 12.567 (44%). Since hospital costs are directly related to the CCI, reduction in complications will lead to cost-effectiveness.
背景/目的：胰十二指肠切除术（PD）后的并发症会导致非计划再入院（UR），使住院费用增加两到三倍。在本研究中，我们旨在了解该患者群体并发症和非计划再入院的费用情况。此外，我们旨在生成一份详细的费用概述，可用于构建理论模型以计算术前康复的成本效益。
使用荷兰胰腺癌审计（DPCA）数据库对2013年至2017年在我院接受胰十二指肠切除术的患者进行回顾性队列分析。收集了首次住院和与胰十二指肠切除术相关的非计划再入院的总费用。
160例患者中，35例（22%）病程无并发症；87例（54%）有轻微并发症，38例（24%）有严重并发症。无并发症病程的中位费用为25,682欧元，有并发症病程的中位费用为32,958欧元（ = 0.001）。轻微并发症的中位费用为30,316欧元，严重并发症的中位费用为42,664欧元（ = 0.001）。费用与综合并发症指数（CCI）相关。有一次或多次非计划再入院的患者的中位费用为41,199欧元。
胰十二指肠切除术后的并发症使住院费用增加了4,634欧元至16,982欧元（18 - 66%）。一次非计划再入院导致费用增加12,567欧元（44%）。由于住院费用与综合并发症指数直接相关，减少并发症将提高成本效益。
