Department of Anaesthesia, Austin Health, Heidelberg, Australia.
Department of Surgery, Austin Health, University of Melbourne, Heidelberg, Australia.
BMC Res Notes. 2024 Feb 27;17(1):59. doi: 10.1186/s13104-024-06720-z.
Postoperative complications following major abdominal surgeries is a pressing concern for hospital care and health economics. Given the paucity of available cost data for patients undergoing major abdominal surgery, we evaluated the number and the severity of postoperative complications following major abdominal surgeries and calculated the costs borne by a single centre university hospital within an Australian healthcare system.
The overall incidence of postoperative complications for 1790 adult patients undergoing major abdominal surgeries (i.e., colonic, liver, small bowel resections and Whipple procedures) between January 2013 and June 2018 was 75.2%. Of these complications, 56.9% were minor (Clavien-Dindo (CVD) Grades I or II) and 15.5% were major (CVD Grades III or IV). As the severity of complications increased, median adjusted total hospital costs rose significantly, with a median (interquartile range [IQR]) of AUD 29,519.70 (IQR 21,828.80-40,527.90) in CVD Grade II versus AUD 50,702.40 (IQR 35,866.00-69,296.80) in CVD Grade III (p <.001). Further, developing one, two or three complications resulted in significantly increased hospital costs by AUD 2618.30 (13.3% increase), AUD 3605.50 (16.2% increase) and AUD 3173.00 (12.3% increase) (p <.0001), respectively, with an exponential spike in costs incurred by patients who developed more than three complications (AUD 23,719.70; 81.7% increase; p < 0001).
腹部大手术后的术后并发症是医院护理和卫生经济学的一个紧迫问题。鉴于可用于接受腹部大手术的患者的成本数据有限，我们评估了 1790 例接受腹部大手术（即结肠、肝脏、小肠切除术和胰十二指肠切除术）的成年患者术后并发症的数量和严重程度，并计算了澳大利亚医疗体系中单家大学医院承担的成本。
2013 年 1 月至 2018 年 6 月期间，1790 例成年患者接受腹部大手术后（即结肠、肝脏、小肠切除术和胰十二指肠切除术）的术后并发症总发生率为 75.2%。这些并发症中，56.9%为轻度（Clavien-Dindo (CVD) 分级 I 或 II），15.5%为重度（CVD 分级 III 或 IV）。随着并发症严重程度的增加，调整后的中位总住院费用显著升高，CVD 分级 II 的中位（四分位间距 [IQR]）为 29519.70 澳元（IQR 21828.80-40527.90），CVD 分级 III 的为 50702.40 澳元（IQR 35866.00-69296.80）（p<.001）。此外，发生 1 种、2 种或 3 种并发症分别导致住院费用显著增加 2618.30 澳元（增加 13.3%）、3605.50 澳元（增加 16.2%）和 3173.00 澳元（增加 12.3%）（p<.0001），而发生 3 种以上并发症的患者的费用呈指数级增长（23719.70 澳元；增加 81.7%；p<.0001）。
