TY - JOUR
T1 - Incidence and Cost of Deep Vein Thrombosis in Emergency General Surgery Over 15 Years
AU - Gantz, Owen
AU - Mulles, Shanen
AU - Zagadailov, Pavel
AU - Merchant, Aziz M.
N1 - Publisher Copyright: © 2020 Elsevier Inc.
PY - 2020/8
Y1 - 2020/8
N2 - Background: Deep vein thromboses (DVTs) are a significant sequela of surgery and are associated with significant of morbidity and mortality in the United States. Operative emergency general surgery (EGS) cases have been demonstrated to have a greater burden of DVT than other types of surgery. Materials and methods: DVT in EGS cases were identified from the National Inpatient Sample–Healthcare Cost and Utilization Project database from 2001 to 2015 Q3 based on ICD-9 code specification. National incidence of DVT in EGS was calculated using the National Inpatient Sample–Healthcare Cost and Utilization Project sampling methodology, and propensity score matching was used to assess costs associated with DVT. Results: Among 15,148,352 sample-weighted hospitalizations, 0.623% (94,392) experienced DVT. Incidence of DVT was greatest in GI ulcer surgery (1.705%) and lowest in appendectomy (0.095%). Patients with a perioperative DVT incurred $22,301 more in hospital-related costs than their counterparts who did not have a DVT. Although rates of DVT remained stable over the period analyzed, DVT-associated costs increased at a 2.09% annual rate in excess of inflation during the period analyzed. This increase in costs was most significant for laparotomy, which increased at a rate of 8.09% annually. Conclusions: DVT continues to be a significant burden on resources in EGS in spite of efforts with DVT prophylaxis. Considering the increase in costs and little change in incidence, further research on cost-effective management of DVT in EGS is warranted.
AB - Background: Deep vein thromboses (DVTs) are a significant sequela of surgery and are associated with significant of morbidity and mortality in the United States. Operative emergency general surgery (EGS) cases have been demonstrated to have a greater burden of DVT than other types of surgery. Materials and methods: DVT in EGS cases were identified from the National Inpatient Sample–Healthcare Cost and Utilization Project database from 2001 to 2015 Q3 based on ICD-9 code specification. National incidence of DVT in EGS was calculated using the National Inpatient Sample–Healthcare Cost and Utilization Project sampling methodology, and propensity score matching was used to assess costs associated with DVT. Results: Among 15,148,352 sample-weighted hospitalizations, 0.623% (94,392) experienced DVT. Incidence of DVT was greatest in GI ulcer surgery (1.705%) and lowest in appendectomy (0.095%). Patients with a perioperative DVT incurred $22,301 more in hospital-related costs than their counterparts who did not have a DVT. Although rates of DVT remained stable over the period analyzed, DVT-associated costs increased at a 2.09% annual rate in excess of inflation during the period analyzed. This increase in costs was most significant for laparotomy, which increased at a rate of 8.09% annually. Conclusions: DVT continues to be a significant burden on resources in EGS in spite of efforts with DVT prophylaxis. Considering the increase in costs and little change in incidence, further research on cost-effective management of DVT in EGS is warranted.
KW - Cost analysis
KW - Deep vein thrombosis
KW - Emergency general surgery
KW - Health economics
KW - Health service
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U2 - https://doi.org/10.1016/j.jss.2020.03.022
DO - https://doi.org/10.1016/j.jss.2020.03.022
M3 - Article
C2 - 32278966
VL - 252
SP - 125
EP - 132
JO - Journal of Surgical Research
JF - Journal of Surgical Research
SN - 0022-4804
ER -