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One-year postoperative resource utilization in sarcopenic patients.
J Surg Res. 2015 Nov; 199(1):51-5.JS

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.

Authors+Show Affiliations

Department of Surgery, Taubman Center, University of Michigan Health System, Ann Arbor, Michigan. Electronic address: pkirk@med.umich.edu.Department of Surgery, Taubman Center, University of Michigan Health System, Ann Arbor, Michigan.Department of Surgery, Taubman Center, University of Michigan Health System, Ann Arbor, Michigan.Department of Surgery, Taubman Center, University of Michigan Health System, Ann Arbor, Michigan.Department of Surgery, Taubman Center, University of Michigan Health System, Ann Arbor, Michigan.Department of Surgery, Taubman Center, University of Michigan Health System, Ann Arbor, Michigan.Department of Surgery, Taubman Center, University of Michigan Health System, Ann Arbor, Michigan.Department of Surgery, Taubman Center, University of Michigan Health System, Ann Arbor, Michigan.

Pub Type(s)

Evaluation Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

25990695

Citation

Kirk, Peter S., et al. "One-year Postoperative Resource Utilization in Sarcopenic Patients." The Journal of Surgical Research, vol. 199, no. 1, 2015, pp. 51-5.
Kirk PS, Friedman JF, Cron DC, et al. One-year postoperative resource utilization in sarcopenic patients. J Surg Res. 2015;199(1):51-5.
Kirk, P. S., Friedman, J. F., Cron, D. C., Terjimanian, M. N., Wang, S. C., Campbell, D. A., Englesbe, M. J., & Werner, N. L. (2015). One-year postoperative resource utilization in sarcopenic patients. The Journal of Surgical Research, 199(1), 51-5. https://doi.org/10.1016/j.jss.2015.04.074
Kirk PS, et al. One-year Postoperative Resource Utilization in Sarcopenic Patients. J Surg Res. 2015;199(1):51-5. PubMed PMID: 25990695.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - One-year postoperative resource utilization in sarcopenic patients. AU - Kirk,Peter S, AU - Friedman,Jeffrey F, AU - Cron,David C, AU - Terjimanian,Michael N, AU - Wang,Stewart C, AU - Campbell,Darrell A, AU - Englesbe,Michael J, AU - Werner,Nicole L, Y1 - 2015/04/30/ PY - 2015/01/03/received PY - 2015/04/12/revised PY - 2015/04/21/accepted PY - 2015/5/21/entrez PY - 2015/5/21/pubmed PY - 2016/1/16/medline KW - Cost KW - Discharge disposition KW - Health care utilization KW - Morphomics KW - Readmissions KW - Sarcopenia SP - 51 EP - 5 JF - The Journal of surgical research JO - J Surg Res VL - 199 IS - 1 N2 - 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. SN - 1095-8673 UR - https://www.unboundmedicine.com/medline/citation/25990695/One_year_postoperative_resource_utilization_in_sarcopenic_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-4804(15)00503-X DB - PRIME DP - Unbound Medicine ER -