Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 May 5;7(3):zrad054.
doi: 10.1093/bjsopen/zrad054.

Global cost of postoperative ileus following abdominal surgery: meta-analysis

Luke Traeger  1   2 , Michalis Koullouros  1   2 , Sergei Bedrikovetski  1   2 , Hidde M Kroon  1   2 , James W Moore  1   2 , Tarik Sammour  1   2
Affiliations
Meta-Analysis

Global cost of postoperative ileus following abdominal surgery: meta-analysis

Luke Traeger et al. BJS Open. .

Abstract

Background: Following abdominal surgery, postoperative ileus is a common complication significantly increasing patient morbidity and cost of hospital admission. This is the first systematic review aimed at determining the average global hospital cost per patient associated with postoperative ileus.

Methods: A systematic search of electronic databases was performed from January 2000 to March 2023. Studies included compared patients undergoing abdominal surgery who developed postoperative ileus to those who did not, focusing on costing data. The primary outcome was the total cost of inpatient stay. Risk of bias was assessed using the Newcastle-Ottawa assessment tool. Summary meta-analysis was performed.

Results: Of the 2071 studies identified, 88 papers were assessed for full eligibility. The systematic review included nine studies (2005-2022), investigating 1 860 889 patients undergoing general, colorectal, gynaecological and urological surgery. These studies showed significant variations in the definition of postoperative ileus. Six studies were eligible for meta-analysis showing an increase of €8233 (95 per cent c.i. (5176 to 11 290), P < 0.0001, I2 = 95.5 per cent) per patient with postoperative ileus resulting in a 66.3 per cent increase in total hospital costs (95 per cent c.i. (34.8 to 97.9), P < 0.0001, I2 = 98.4 per cent). However, there was significant bias between studies. Five colorectal-surgery-specific studies showed an increase of €7242 (95 per cent c.i. (4502 to 9983), P < 0.0001, I2 = 86.0 per cent) per patient with postoperative ileus resulting in a 57.3 per cent increase in total hospital costs (95 per cent c.i. (36.3 to 78.3), P < 0.0001, I2 = 85.7 per cent).

Conclusion: The global financial burden of postoperative ileus following abdominal surgery is significant. While further multicentre data using a uniform postoperative ileus definition would be useful, reducing the incidence and impact of postoperative ileus are a priority to mitigate healthcare-related costs, and improve patient outcomes.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
PRISMA flow chart Adapted from Page et al.
Fig. 2
Fig. 2
Meta-analysis plots a Mean difference and b percentage difference.
Fig. 3
Fig. 3
Meta-analysis plots a Mean difference and b percentage difference for colorectal studies.
See this image and copyright information in PMC

References

    1. Vather R, Bissett I. Management of prolonged post-operative ileus: evidence-based recommendations. ANZ J Surg 2013;83:319–324 - PubMed
    1. Alhashemi M, Fiore JF Jr, Safa N, Al Mahroos M, Mata J, Pecorelli Net al. . Incidence and predictors of prolonged postoperative ileus after colorectal surgery in the context of an enhanced recovery pathway. Surg Endosc 2019;33:2313–2322 - PubMed
    1. Ceretti AP, Maroni N, Longhi M, Giovenzana M, Santambrogio R, Barabino Met al. . Risk factors for prolonged postoperative ileus in adult patients undergoing elective colorectal surgery: an observational cohort study. Rev Recent Clin Trials 2018;13:295–304 - PubMed
    1. Wolthuis AM, Bislenghi G, Fieuws S, de Buck van Overstraeten A, Boeckxstaens G, D'Hoore A. Incidence of prolonged postoperative ileus after colorectal surgery: a systematic review and meta-analysis. Colorectal Dis 2016;18:O1–O9 - PubMed
    1. Li Z-L, Zhao B-C, Deng W-T, Zhuang P-P, Liu W-F, Li Cet al. . Incidence and risk factors of postoperative ileus after hysterectomy for benign indications. Int J Colorectal Dis 2020;35:2105–2112 - PubMed

Publication types

MeSH terms