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. 2023 Feb 25:2023:1844690.
doi: 10.1155/2023/1844690. eCollection 2023.

Economic Consequences of Surgery for Adhesive Small Bowel Obstruction: A Population-Based Study

Thorbjörn Sakari  1   2 , Sophie Langenskiöld  3 , Filip Sköldberg  2 , Urban Karlbom  2
Affiliations

Economic Consequences of Surgery for Adhesive Small Bowel Obstruction: A Population-Based Study

Thorbjörn Sakari et al. Gastroenterol Res Pract. .

Abstract

Background and aims: Most patients develop adhesions after abdominal surgery, some will be hospitalized with small bowel obstruction (SBO), and some also require surgery. The operations and follow-up are expensive, but recent data of costs are scarce. The aim of this study was to describe the direct costs of SBO-surgery and follow-up, in a population-based setting. The association between cost of SBO and peri- and postoperative data was also studied.

Methods: In a retrospective cohort study, all patients (n = 402) operated for adhesive SBO in Gävleborg and Uppsala counties (2007-2012) were studied. The median follow-up was 8 years. Costs were calculated according to the pricelist of Uppsala University Hospital, Uppsala, Sweden.

Results: Overall total costs were €16.267 million, corresponding to a mean total cost per patient of €40,467 during the studied period. Diffuse adhesions and postoperative complications were associated with increased costs for SBO in a multivariable analysis (P < 0.001). Most costs, about €14 million (85%), arouse in conjunction with the SBO-index surgery period. In-hospital stay was the dominating cost, accounting for 70% of the total costs.

Conclusion: Surgery for SBO generates substantial economic burden for healthcare systems. Measures that reduce the incidence of SBO, the frequency of postoperative complication, or the length of stay have the potential to reduce this economic burden. The cost estimates from this study may be valuable for future cost-benefit analyses in intervention studies.

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Conflict of interest statement

The author(s) declare(s) that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Total costs (€) and numbers at risk each year during the follow-up period after index SBO-surgery.
Figure 2
Figure 2
Total costs (€) for index SBO-surgery and the follow-up period. Data are presented for all patients and separately stratified by mechanism of obstruction, bowel injury, and postoperative complication. Numbers on the sides of the graphs represent mean cost per patient.
See this image and copyright information in PMC

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