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. 2015 Nov;199(1):51-5.
doi: 10.1016/j.jss.2015.04.074. Epub 2015 Apr 30.

One-year postoperative resource utilization in sarcopenic patients

Peter S Kirk  1 , Jeffrey F Friedman  2 , David C Cron  2 , Michael N Terjimanian  2 , Stewart C Wang  2 , Darrell A Campbell  2 , Michael J Englesbe  2 , Nicole L Werner  2
Affiliations

One-year postoperative resource utilization in sarcopenic patients

Peter S Kirk et al. J Surg Res. 2015 Nov.

Abstract

Background: It is well established that sarcopenic patients are at higher risk of postoperative complications and short-term health care utilization. Less well understood is how these patients fare over the long term after surviving the immediate postoperative period. We explored costs over the first postoperative year among sarcopenic patients.

Methods: We identified 1279 patients in the Michigan Surgical Quality Collaborative database who underwent inpatient elective surgery at a single institution from 2006-2011. Sarcopenia, defined by gender-stratified tertiles of lean psoas area, was determined from preoperative computed tomography scans using validated analytic morphomics. Data were analyzed to assess sarcopenia's relationship to costs, readmissions, discharge location, intensive care unit admissions, hospital length of stay, and mortality. Multivariate models were adjusted for patient demographics and surgical risk factors.

Results: Sarcopenia was independently associated with increased adjusted costs at 30, 90, and 180 but not 365 d. The difference in adjusted postsurgical costs between sarcopenic and nonsarcopenic patients was $16,455 at 30 d and $14,093 at 1 y. Sarcopenic patients were more likely to be discharged somewhere other than home (P < 0.001). Sarcopenia was not an independent predictor of increased readmission rates in the postsurgical year.

Conclusions: The effects of sarcopenia on health care costs are concentrated in the immediate postoperative period. It may be appropriate to allocate additional resources to sarcopenic patients in the perioperative setting to reduce the incidence of negative postoperative outcomes.

Keywords: Cost; Discharge disposition; Health care utilization; Morphomics; Readmissions; Sarcopenia.

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Figures

Figure 1
Figure 1
Adjusted rates of discharge to somewhere other than home across tertiles of lean psoas area. Small (sarcopenic) lean psoas area patients had a significantly greater percentage of non-home discharges compared to large (non-sarcopenic) lean psoas area patients.
Figure 2
Figure 2
Adjusted costs in sarcopenic and non-sarcopenic patients through the postoperative year (mean with 95% CI). Sarcopenic status was independently associated with increased costs at 1, 3, and 6 months but not at 1 year.
See this image and copyright information in PMC

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