Impact of postcolectomy adhesion-related complications on healthcare utilization

Katherine Etter,1 Nadia Sutton,2 David Wei,3 Andrew Yoo3 1Medical Devices-Epidemiology, Johnson and Johnson, Raynham, MA 02767, USA; 2Ethicon HEMA, Somerville, NJ 08876, USA; 3Medical Devices-Epidemiology, Johnson and Johnson, New Brunswick, NJ 08901, USA Objective: The objective of this study was to explore adhesion-related complications (ARCs) within 1 year after colectomy.Methods: Using Truven MarketScan® Commercial and Medicare databases, the first inpatient colectomies during 2009–2013 (index) were identified: left, right, partial, transverse, or total. One-year continuous enrollment was required pre and postindex. Only the first inpatient rehospitalization event was analyzed. ARC was defined as the subset of rehospitalizations with a diagnosis of ileus, small bowel obstruction, or postindex adhesiolysis. ARC and non-ARC events were evaluated descriptively, including time to ARC, length of stay (LOS), and total hospitalization reimbursement (2015 US dollars [2015 USD]). Patient, provider, and procedure factors associated with ARC were explored using logistic regression models.Results: A total of 64,532 colectomies were identified: left (39.2%), right (34.9%), partial (20.0%), transverse (2.3%), and total (3.6%). Surgical approach was classified as open (60.1%) and laparoscopic (39.9%). All-cause first inpatient readmission incidence within 1 year was 24.7%, and ARC incidence was 5.7% in all patients or 23.2% in all first readmissions. ARC had statistically higher resource utilization compared to non-ARC with respective mean (SD) time to event (130 [102] and 137 [106] days), mean (SD) LOS (7.2 [8.0] and 5.2 [6.8] days), and mean (SD) total reimbursement ($29,802 [$43,037] and $22,476 [$36,130]). ARC risk factors included (OR [95% CI]) resection type (total vs right, 3.78 [3.27–4.36]), left vs right (1.69 [1.53–1.86]), adhesiolysis (2.45 [1.42–4.23]), computerized tomography (1.79 [1.65–1.95]), surgical indication: inflammatory bowel disease vs cancer (1.69 [1.43–1.99]), and multiple abdominal procedures (1.38 [1.29–1.49]). Laparoscopic approach was protective (0.42 [0.39–0.46]).Conclusion: ARCs were associated with almost one-fourth of all first rehospitalizations within the first year after colectomy and were associated with substantial healthcare utilization. Risk factors included increased index colectomy complexity, while the laparoscopic approach was protective. Future research is needed to better identify high-risk patients and allow for appropriate economic and clinical risk adjustment of outcomes. Keywords: bowel obstruction, ileus, rehospitalization Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Etter K [verfasserIn] Sutton N [verfasserIn] Wei D [verfasserIn] Yoo A [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2018

Schlagwörter:	Colorectal surgery Adhesions Complications

Übergeordnetes Werk:	In: ClinicoEconomics and Outcomes Research - Dove Medical Press, 2010, (2018), Seite 761-771
Übergeordnetes Werk:	year:2018 ; pages:761-771

Links:	Link aufrufen Link aufrufen Journal toc

Katalog-ID:	DOAJ041710754

Internformat


LEADER	01000caa a22002652 4500
001	DOAJ041710754
003	DE-627
005	20230308052027.0
007	cr uuu---uuuuu
008	230227s2018 xx \|\|\|\|\|o 00\| \|\|eng c
035			\|a (DE-627)DOAJ041710754
035			\|a (DE-599)DOAJb336c1ea58204a2b86f23ffcd7a0f827
040			\|a DE-627 \|b ger \|c DE-627 \|e rakwb
041			\|a eng
050		0	\|a R5-920
050		0	\|a RM1-950
100	0		\|a Etter K \|e verfasserin \|4 aut
245	1	0	\|a Impact of postcolectomy adhesion-related complications on healthcare utilization
264		1	\|c 2018
336			\|a Text \|b txt \|2 rdacontent
337			\|a Computermedien \|b c \|2 rdamedia
338			\|a Online-Ressource \|b cr \|2 rdacarrier
520			\|a Katherine Etter,1 Nadia Sutton,2 David Wei,3 Andrew Yoo3 1Medical Devices-Epidemiology, Johnson and Johnson, Raynham, MA 02767, USA; 2Ethicon HEMA, Somerville, NJ 08876, USA; 3Medical Devices-Epidemiology, Johnson and Johnson, New Brunswick, NJ 08901, USA Objective: The objective of this study was to explore adhesion-related complications (ARCs) within 1 year after colectomy.Methods: Using Truven MarketScan® Commercial and Medicare databases, the first inpatient colectomies during 2009–2013 (index) were identified: left, right, partial, transverse, or total. One-year continuous enrollment was required pre and postindex. Only the first inpatient rehospitalization event was analyzed. ARC was defined as the subset of rehospitalizations with a diagnosis of ileus, small bowel obstruction, or postindex adhesiolysis. ARC and non-ARC events were evaluated descriptively, including time to ARC, length of stay (LOS), and total hospitalization reimbursement (2015 US dollars [2015 USD]). Patient, provider, and procedure factors associated with ARC were explored using logistic regression models.Results: A total of 64,532 colectomies were identified: left (39.2%), right (34.9%), partial (20.0%), transverse (2.3%), and total (3.6%). Surgical approach was classified as open (60.1%) and laparoscopic (39.9%). All-cause first inpatient readmission incidence within 1 year was 24.7%, and ARC incidence was 5.7% in all patients or 23.2% in all first readmissions. ARC had statistically higher resource utilization compared to non-ARC with respective mean (SD) time to event (130 [102] and 137 [106] days), mean (SD) LOS (7.2 [8.0] and 5.2 [6.8] days), and mean (SD) total reimbursement ($29,802 [$43,037] and $22,476 [$36,130]). ARC risk factors included (OR [95% CI]) resection type (total vs right, 3.78 [3.27–4.36]), left vs right (1.69 [1.53–1.86]), adhesiolysis (2.45 [1.42–4.23]), computerized tomography (1.79 [1.65–1.95]), surgical indication: inflammatory bowel disease vs cancer (1.69 [1.43–1.99]), and multiple abdominal procedures (1.38 [1.29–1.49]). Laparoscopic approach was protective (0.42 [0.39–0.46]).Conclusion: ARCs were associated with almost one-fourth of all first rehospitalizations within the first year after colectomy and were associated with substantial healthcare utilization. Risk factors included increased index colectomy complexity, while the laparoscopic approach was protective. Future research is needed to better identify high-risk patients and allow for appropriate economic and clinical risk adjustment of outcomes. Keywords: bowel obstruction, ileus, rehospitalization
650		4	\|a Colorectal surgery
650		4	\|a Adhesions
650		4	\|a Complications
653		0	\|a Medicine (General)
653		0	\|a Therapeutics. Pharmacology
700	0		\|a Sutton N \|e verfasserin \|4 aut
700	0		\|a Wei D \|e verfasserin \|4 aut
700	0		\|a Yoo A \|e verfasserin \|4 aut
773	0	8	\|i In \|t ClinicoEconomics and Outcomes Research \|d Dove Medical Press, 2010 \|g (2018), Seite 761-771 \|w (DE-627)611725843 \|w (DE-600)2520698-9 \|x 11786981 \|7 nnns
773	1	8	\|g year:2018 \|g pages:761-771
856	4	0	\|u https://doaj.org/article/b336c1ea58204a2b86f23ffcd7a0f827 \|z kostenfrei
856	4	0	\|u https://www.dovepress.com/impact-of-postcolectomy-adhesion-related-complications-on-healthcare-u-peer-reviewed-article-CEOR \|z kostenfrei
856	4	2	\|u https://doaj.org/toc/1178-6981 \|y Journal toc \|z kostenfrei
912			\|a GBV_USEFLAG_A
912			\|a SYSFLAG_A
912			\|a GBV_DOAJ
912			\|a GBV_ILN_11
912			\|a GBV_ILN_20
912			\|a GBV_ILN_22
912			\|a GBV_ILN_23
912			\|a GBV_ILN_24
912			\|a GBV_ILN_39
912			\|a GBV_ILN_40
912			\|a GBV_ILN_60
912			\|a GBV_ILN_62
912			\|a GBV_ILN_63
912			\|a GBV_ILN_65
912			\|a GBV_ILN_69
912			\|a GBV_ILN_73
912			\|a GBV_ILN_74
912			\|a GBV_ILN_95
912			\|a GBV_ILN_105
912			\|a GBV_ILN_110
912			\|a GBV_ILN_151
912			\|a GBV_ILN_161
912			\|a GBV_ILN_170
912			\|a GBV_ILN_206
912			\|a GBV_ILN_213
912			\|a GBV_ILN_230
912			\|a GBV_ILN_285
912			\|a GBV_ILN_293
912			\|a GBV_ILN_602
912			\|a GBV_ILN_2003
912			\|a GBV_ILN_2014
912			\|a GBV_ILN_4012
912			\|a GBV_ILN_4037
912			\|a GBV_ILN_4112
912			\|a GBV_ILN_4125
912			\|a GBV_ILN_4126
912			\|a GBV_ILN_4249
912			\|a GBV_ILN_4305
912			\|a GBV_ILN_4306
912			\|a GBV_ILN_4307
912			\|a GBV_ILN_4313
912			\|a GBV_ILN_4322
912			\|a GBV_ILN_4323
912			\|a GBV_ILN_4324
912			\|a GBV_ILN_4325
912			\|a GBV_ILN_4326
912			\|a GBV_ILN_4335
912			\|a GBV_ILN_4338
912			\|a GBV_ILN_4367
912			\|a GBV_ILN_4700
951			\|a AR
952			\|j 2018 \|h 761-771

Indexfelder

author_variant	e k ek s n sn w d wd y a ya
matchkey_str	article:11786981:2018----::matfotoetmahsorltdopiainoha
hierarchy_sort_str	2018
callnumber-subject-code	R
publishDate	2018
allfields	(DE-627)DOAJ041710754 (DE-599)DOAJb336c1ea58204a2b86f23ffcd7a0f827 DE-627 ger DE-627 rakwb eng R5-920 RM1-950 Etter K verfasserin aut Impact of postcolectomy adhesion-related complications on healthcare utilization 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Katherine Etter,1 Nadia Sutton,2 David Wei,3 Andrew Yoo3 1Medical Devices-Epidemiology, Johnson and Johnson, Raynham, MA 02767, USA; 2Ethicon HEMA, Somerville, NJ 08876, USA; 3Medical Devices-Epidemiology, Johnson and Johnson, New Brunswick, NJ 08901, USA Objective: The objective of this study was to explore adhesion-related complications (ARCs) within 1 year after colectomy.Methods: Using Truven MarketScan® Commercial and Medicare databases, the first inpatient colectomies during 2009–2013 (index) were identified: left, right, partial, transverse, or total. One-year continuous enrollment was required pre and postindex. Only the first inpatient rehospitalization event was analyzed. ARC was defined as the subset of rehospitalizations with a diagnosis of ileus, small bowel obstruction, or postindex adhesiolysis. ARC and non-ARC events were evaluated descriptively, including time to ARC, length of stay (LOS), and total hospitalization reimbursement (2015 US dollars [2015 USD]). Patient, provider, and procedure factors associated with ARC were explored using logistic regression models.Results: A total of 64,532 colectomies were identified: left (39.2%), right (34.9%), partial (20.0%), transverse (2.3%), and total (3.6%). Surgical approach was classified as open (60.1%) and laparoscopic (39.9%). All-cause first inpatient readmission incidence within 1 year was 24.7%, and ARC incidence was 5.7% in all patients or 23.2% in all first readmissions. ARC had statistically higher resource utilization compared to non-ARC with respective mean (SD) time to event (130 [102] and 137 [106] days), mean (SD) LOS (7.2 [8.0] and 5.2 [6.8] days), and mean (SD) total reimbursement ($29,802 [$43,037] and $22,476 [$36,130]). ARC risk factors included (OR [95% CI]) resection type (total vs right, 3.78 [3.27–4.36]), left vs right (1.69 [1.53–1.86]), adhesiolysis (2.45 [1.42–4.23]), computerized tomography (1.79 [1.65–1.95]), surgical indication: inflammatory bowel disease vs cancer (1.69 [1.43–1.99]), and multiple abdominal procedures (1.38 [1.29–1.49]). Laparoscopic approach was protective (0.42 [0.39–0.46]).Conclusion: ARCs were associated with almost one-fourth of all first rehospitalizations within the first year after colectomy and were associated with substantial healthcare utilization. Risk factors included increased index colectomy complexity, while the laparoscopic approach was protective. Future research is needed to better identify high-risk patients and allow for appropriate economic and clinical risk adjustment of outcomes. Keywords: bowel obstruction, ileus, rehospitalization Colorectal surgery Adhesions Complications Medicine (General) Therapeutics. Pharmacology Sutton N verfasserin aut Wei D verfasserin aut Yoo A verfasserin aut In ClinicoEconomics and Outcomes Research Dove Medical Press, 2010 (2018), Seite 761-771 (DE-627)611725843 (DE-600)2520698-9 11786981 nnns year:2018 pages:761-771 https://doaj.org/article/b336c1ea58204a2b86f23ffcd7a0f827 kostenfrei https://www.dovepress.com/impact-of-postcolectomy-adhesion-related-complications-on-healthcare-u-peer-reviewed-article-CEOR kostenfrei https://doaj.org/toc/1178-6981 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2018 761-771
spelling	(DE-627)DOAJ041710754 (DE-599)DOAJb336c1ea58204a2b86f23ffcd7a0f827 DE-627 ger DE-627 rakwb eng R5-920 RM1-950 Etter K verfasserin aut Impact of postcolectomy adhesion-related complications on healthcare utilization 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Katherine Etter,1 Nadia Sutton,2 David Wei,3 Andrew Yoo3 1Medical Devices-Epidemiology, Johnson and Johnson, Raynham, MA 02767, USA; 2Ethicon HEMA, Somerville, NJ 08876, USA; 3Medical Devices-Epidemiology, Johnson and Johnson, New Brunswick, NJ 08901, USA Objective: The objective of this study was to explore adhesion-related complications (ARCs) within 1 year after colectomy.Methods: Using Truven MarketScan® Commercial and Medicare databases, the first inpatient colectomies during 2009–2013 (index) were identified: left, right, partial, transverse, or total. One-year continuous enrollment was required pre and postindex. Only the first inpatient rehospitalization event was analyzed. ARC was defined as the subset of rehospitalizations with a diagnosis of ileus, small bowel obstruction, or postindex adhesiolysis. ARC and non-ARC events were evaluated descriptively, including time to ARC, length of stay (LOS), and total hospitalization reimbursement (2015 US dollars [2015 USD]). Patient, provider, and procedure factors associated with ARC were explored using logistic regression models.Results: A total of 64,532 colectomies were identified: left (39.2%), right (34.9%), partial (20.0%), transverse (2.3%), and total (3.6%). Surgical approach was classified as open (60.1%) and laparoscopic (39.9%). All-cause first inpatient readmission incidence within 1 year was 24.7%, and ARC incidence was 5.7% in all patients or 23.2% in all first readmissions. ARC had statistically higher resource utilization compared to non-ARC with respective mean (SD) time to event (130 [102] and 137 [106] days), mean (SD) LOS (7.2 [8.0] and 5.2 [6.8] days), and mean (SD) total reimbursement ($29,802 [$43,037] and $22,476 [$36,130]). ARC risk factors included (OR [95% CI]) resection type (total vs right, 3.78 [3.27–4.36]), left vs right (1.69 [1.53–1.86]), adhesiolysis (2.45 [1.42–4.23]), computerized tomography (1.79 [1.65–1.95]), surgical indication: inflammatory bowel disease vs cancer (1.69 [1.43–1.99]), and multiple abdominal procedures (1.38 [1.29–1.49]). Laparoscopic approach was protective (0.42 [0.39–0.46]).Conclusion: ARCs were associated with almost one-fourth of all first rehospitalizations within the first year after colectomy and were associated with substantial healthcare utilization. Risk factors included increased index colectomy complexity, while the laparoscopic approach was protective. Future research is needed to better identify high-risk patients and allow for appropriate economic and clinical risk adjustment of outcomes. Keywords: bowel obstruction, ileus, rehospitalization Colorectal surgery Adhesions Complications Medicine (General) Therapeutics. Pharmacology Sutton N verfasserin aut Wei D verfasserin aut Yoo A verfasserin aut In ClinicoEconomics and Outcomes Research Dove Medical Press, 2010 (2018), Seite 761-771 (DE-627)611725843 (DE-600)2520698-9 11786981 nnns year:2018 pages:761-771 https://doaj.org/article/b336c1ea58204a2b86f23ffcd7a0f827 kostenfrei https://www.dovepress.com/impact-of-postcolectomy-adhesion-related-complications-on-healthcare-u-peer-reviewed-article-CEOR kostenfrei https://doaj.org/toc/1178-6981 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2018 761-771
allfields_unstemmed	(DE-627)DOAJ041710754 (DE-599)DOAJb336c1ea58204a2b86f23ffcd7a0f827 DE-627 ger DE-627 rakwb eng R5-920 RM1-950 Etter K verfasserin aut Impact of postcolectomy adhesion-related complications on healthcare utilization 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Katherine Etter,1 Nadia Sutton,2 David Wei,3 Andrew Yoo3 1Medical Devices-Epidemiology, Johnson and Johnson, Raynham, MA 02767, USA; 2Ethicon HEMA, Somerville, NJ 08876, USA; 3Medical Devices-Epidemiology, Johnson and Johnson, New Brunswick, NJ 08901, USA Objective: The objective of this study was to explore adhesion-related complications (ARCs) within 1 year after colectomy.Methods: Using Truven MarketScan® Commercial and Medicare databases, the first inpatient colectomies during 2009–2013 (index) were identified: left, right, partial, transverse, or total. One-year continuous enrollment was required pre and postindex. Only the first inpatient rehospitalization event was analyzed. ARC was defined as the subset of rehospitalizations with a diagnosis of ileus, small bowel obstruction, or postindex adhesiolysis. ARC and non-ARC events were evaluated descriptively, including time to ARC, length of stay (LOS), and total hospitalization reimbursement (2015 US dollars [2015 USD]). Patient, provider, and procedure factors associated with ARC were explored using logistic regression models.Results: A total of 64,532 colectomies were identified: left (39.2%), right (34.9%), partial (20.0%), transverse (2.3%), and total (3.6%). Surgical approach was classified as open (60.1%) and laparoscopic (39.9%). All-cause first inpatient readmission incidence within 1 year was 24.7%, and ARC incidence was 5.7% in all patients or 23.2% in all first readmissions. ARC had statistically higher resource utilization compared to non-ARC with respective mean (SD) time to event (130 [102] and 137 [106] days), mean (SD) LOS (7.2 [8.0] and 5.2 [6.8] days), and mean (SD) total reimbursement ($29,802 [$43,037] and $22,476 [$36,130]). ARC risk factors included (OR [95% CI]) resection type (total vs right, 3.78 [3.27–4.36]), left vs right (1.69 [1.53–1.86]), adhesiolysis (2.45 [1.42–4.23]), computerized tomography (1.79 [1.65–1.95]), surgical indication: inflammatory bowel disease vs cancer (1.69 [1.43–1.99]), and multiple abdominal procedures (1.38 [1.29–1.49]). Laparoscopic approach was protective (0.42 [0.39–0.46]).Conclusion: ARCs were associated with almost one-fourth of all first rehospitalizations within the first year after colectomy and were associated with substantial healthcare utilization. Risk factors included increased index colectomy complexity, while the laparoscopic approach was protective. Future research is needed to better identify high-risk patients and allow for appropriate economic and clinical risk adjustment of outcomes. Keywords: bowel obstruction, ileus, rehospitalization Colorectal surgery Adhesions Complications Medicine (General) Therapeutics. Pharmacology Sutton N verfasserin aut Wei D verfasserin aut Yoo A verfasserin aut In ClinicoEconomics and Outcomes Research Dove Medical Press, 2010 (2018), Seite 761-771 (DE-627)611725843 (DE-600)2520698-9 11786981 nnns year:2018 pages:761-771 https://doaj.org/article/b336c1ea58204a2b86f23ffcd7a0f827 kostenfrei https://www.dovepress.com/impact-of-postcolectomy-adhesion-related-complications-on-healthcare-u-peer-reviewed-article-CEOR kostenfrei https://doaj.org/toc/1178-6981 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2018 761-771
allfieldsGer	(DE-627)DOAJ041710754 (DE-599)DOAJb336c1ea58204a2b86f23ffcd7a0f827 DE-627 ger DE-627 rakwb eng R5-920 RM1-950 Etter K verfasserin aut Impact of postcolectomy adhesion-related complications on healthcare utilization 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Katherine Etter,1 Nadia Sutton,2 David Wei,3 Andrew Yoo3 1Medical Devices-Epidemiology, Johnson and Johnson, Raynham, MA 02767, USA; 2Ethicon HEMA, Somerville, NJ 08876, USA; 3Medical Devices-Epidemiology, Johnson and Johnson, New Brunswick, NJ 08901, USA Objective: The objective of this study was to explore adhesion-related complications (ARCs) within 1 year after colectomy.Methods: Using Truven MarketScan® Commercial and Medicare databases, the first inpatient colectomies during 2009–2013 (index) were identified: left, right, partial, transverse, or total. One-year continuous enrollment was required pre and postindex. Only the first inpatient rehospitalization event was analyzed. ARC was defined as the subset of rehospitalizations with a diagnosis of ileus, small bowel obstruction, or postindex adhesiolysis. ARC and non-ARC events were evaluated descriptively, including time to ARC, length of stay (LOS), and total hospitalization reimbursement (2015 US dollars [2015 USD]). Patient, provider, and procedure factors associated with ARC were explored using logistic regression models.Results: A total of 64,532 colectomies were identified: left (39.2%), right (34.9%), partial (20.0%), transverse (2.3%), and total (3.6%). Surgical approach was classified as open (60.1%) and laparoscopic (39.9%). All-cause first inpatient readmission incidence within 1 year was 24.7%, and ARC incidence was 5.7% in all patients or 23.2% in all first readmissions. ARC had statistically higher resource utilization compared to non-ARC with respective mean (SD) time to event (130 [102] and 137 [106] days), mean (SD) LOS (7.2 [8.0] and 5.2 [6.8] days), and mean (SD) total reimbursement ($29,802 [$43,037] and $22,476 [$36,130]). ARC risk factors included (OR [95% CI]) resection type (total vs right, 3.78 [3.27–4.36]), left vs right (1.69 [1.53–1.86]), adhesiolysis (2.45 [1.42–4.23]), computerized tomography (1.79 [1.65–1.95]), surgical indication: inflammatory bowel disease vs cancer (1.69 [1.43–1.99]), and multiple abdominal procedures (1.38 [1.29–1.49]). Laparoscopic approach was protective (0.42 [0.39–0.46]).Conclusion: ARCs were associated with almost one-fourth of all first rehospitalizations within the first year after colectomy and were associated with substantial healthcare utilization. Risk factors included increased index colectomy complexity, while the laparoscopic approach was protective. Future research is needed to better identify high-risk patients and allow for appropriate economic and clinical risk adjustment of outcomes. Keywords: bowel obstruction, ileus, rehospitalization Colorectal surgery Adhesions Complications Medicine (General) Therapeutics. Pharmacology Sutton N verfasserin aut Wei D verfasserin aut Yoo A verfasserin aut In ClinicoEconomics and Outcomes Research Dove Medical Press, 2010 (2018), Seite 761-771 (DE-627)611725843 (DE-600)2520698-9 11786981 nnns year:2018 pages:761-771 https://doaj.org/article/b336c1ea58204a2b86f23ffcd7a0f827 kostenfrei https://www.dovepress.com/impact-of-postcolectomy-adhesion-related-complications-on-healthcare-u-peer-reviewed-article-CEOR kostenfrei https://doaj.org/toc/1178-6981 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2018 761-771
allfieldsSound	(DE-627)DOAJ041710754 (DE-599)DOAJb336c1ea58204a2b86f23ffcd7a0f827 DE-627 ger DE-627 rakwb eng R5-920 RM1-950 Etter K verfasserin aut Impact of postcolectomy adhesion-related complications on healthcare utilization 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Katherine Etter,1 Nadia Sutton,2 David Wei,3 Andrew Yoo3 1Medical Devices-Epidemiology, Johnson and Johnson, Raynham, MA 02767, USA; 2Ethicon HEMA, Somerville, NJ 08876, USA; 3Medical Devices-Epidemiology, Johnson and Johnson, New Brunswick, NJ 08901, USA Objective: The objective of this study was to explore adhesion-related complications (ARCs) within 1 year after colectomy.Methods: Using Truven MarketScan® Commercial and Medicare databases, the first inpatient colectomies during 2009–2013 (index) were identified: left, right, partial, transverse, or total. One-year continuous enrollment was required pre and postindex. Only the first inpatient rehospitalization event was analyzed. ARC was defined as the subset of rehospitalizations with a diagnosis of ileus, small bowel obstruction, or postindex adhesiolysis. ARC and non-ARC events were evaluated descriptively, including time to ARC, length of stay (LOS), and total hospitalization reimbursement (2015 US dollars [2015 USD]). Patient, provider, and procedure factors associated with ARC were explored using logistic regression models.Results: A total of 64,532 colectomies were identified: left (39.2%), right (34.9%), partial (20.0%), transverse (2.3%), and total (3.6%). Surgical approach was classified as open (60.1%) and laparoscopic (39.9%). All-cause first inpatient readmission incidence within 1 year was 24.7%, and ARC incidence was 5.7% in all patients or 23.2% in all first readmissions. ARC had statistically higher resource utilization compared to non-ARC with respective mean (SD) time to event (130 [102] and 137 [106] days), mean (SD) LOS (7.2 [8.0] and 5.2 [6.8] days), and mean (SD) total reimbursement ($29,802 [$43,037] and $22,476 [$36,130]). ARC risk factors included (OR [95% CI]) resection type (total vs right, 3.78 [3.27–4.36]), left vs right (1.69 [1.53–1.86]), adhesiolysis (2.45 [1.42–4.23]), computerized tomography (1.79 [1.65–1.95]), surgical indication: inflammatory bowel disease vs cancer (1.69 [1.43–1.99]), and multiple abdominal procedures (1.38 [1.29–1.49]). Laparoscopic approach was protective (0.42 [0.39–0.46]).Conclusion: ARCs were associated with almost one-fourth of all first rehospitalizations within the first year after colectomy and were associated with substantial healthcare utilization. Risk factors included increased index colectomy complexity, while the laparoscopic approach was protective. Future research is needed to better identify high-risk patients and allow for appropriate economic and clinical risk adjustment of outcomes. Keywords: bowel obstruction, ileus, rehospitalization Colorectal surgery Adhesions Complications Medicine (General) Therapeutics. Pharmacology Sutton N verfasserin aut Wei D verfasserin aut Yoo A verfasserin aut In ClinicoEconomics and Outcomes Research Dove Medical Press, 2010 (2018), Seite 761-771 (DE-627)611725843 (DE-600)2520698-9 11786981 nnns year:2018 pages:761-771 https://doaj.org/article/b336c1ea58204a2b86f23ffcd7a0f827 kostenfrei https://www.dovepress.com/impact-of-postcolectomy-adhesion-related-complications-on-healthcare-u-peer-reviewed-article-CEOR kostenfrei https://doaj.org/toc/1178-6981 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2018 761-771
language	English
source	In ClinicoEconomics and Outcomes Research (2018), Seite 761-771 year:2018 pages:761-771
sourceStr	In ClinicoEconomics and Outcomes Research (2018), Seite 761-771 year:2018 pages:761-771
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Colorectal surgery Adhesions Complications Medicine (General) Therapeutics. Pharmacology
isfreeaccess_bool	true
container_title	ClinicoEconomics and Outcomes Research
authorswithroles_txt_mv	Etter K @@aut@@ Sutton N @@aut@@ Wei D @@aut@@ Yoo A @@aut@@
publishDateDaySort_date	2018-01-01T00:00:00Z
hierarchy_top_id	611725843
id	DOAJ041710754
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">DOAJ041710754</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230308052027.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230227s2018 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ041710754</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJb336c1ea58204a2b86f23ffcd7a0f827</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">R5-920</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RM1-950</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">Etter K</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Impact of postcolectomy adhesion-related complications on healthcare utilization</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2018</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Katherine Etter,1 Nadia Sutton,2 David Wei,3 Andrew Yoo3 1Medical Devices-Epidemiology, Johnson and Johnson, Raynham, MA 02767, USA; 2Ethicon HEMA, Somerville, NJ 08876, USA; 3Medical Devices-Epidemiology, Johnson and Johnson, New Brunswick, NJ 08901, USA Objective: The objective of this study was to explore adhesion-related complications (ARCs) within 1 year after colectomy.Methods: Using Truven MarketScan&reg; Commercial and Medicare databases, the first inpatient colectomies during 2009&ndash;2013 (index) were identified: left, right, partial, transverse, or total. One-year continuous enrollment was required pre and postindex. Only the first inpatient rehospitalization event was analyzed. ARC was defined as the subset of rehospitalizations with a diagnosis of ileus, small bowel obstruction, or postindex adhesiolysis. ARC and non-ARC events were evaluated descriptively, including time to ARC, length of stay (LOS), and total hospitalization reimbursement (2015 US dollars [2015 USD]). Patient, provider, and procedure factors associated with ARC were explored using logistic regression models.Results: A total of 64,532 colectomies were identified: left (39.2%), right (34.9%), partial (20.0%), transverse (2.3%), and total (3.6%). Surgical approach was classified as open (60.1%) and laparoscopic (39.9%). All-cause first inpatient readmission incidence within 1 year was 24.7%, and ARC incidence was 5.7% in all patients or 23.2% in all first readmissions. ARC had statistically higher resource utilization compared to non-ARC with respective mean (SD) time to event (130 [102] and 137 [106] days), mean (SD) LOS (7.2 [8.0] and 5.2 [6.8] days), and mean (SD) total reimbursement ($29,802 [$43,037] and $22,476 [$36,130]). ARC risk factors included (OR [95% CI]) resection type (total vs right, 3.78 [3.27&ndash;4.36]), left vs right (1.69 [1.53&ndash;1.86]), adhesiolysis (2.45 [1.42&ndash;4.23]), computerized tomography (1.79 [1.65&ndash;1.95]), surgical indication: inflammatory bowel disease vs cancer (1.69 [1.43&ndash;1.99]), and multiple abdominal procedures (1.38 [1.29&ndash;1.49]). Laparoscopic approach was protective (0.42 [0.39&ndash;0.46]).Conclusion: ARCs were associated with almost one-fourth of all first rehospitalizations within the first year after colectomy and were associated with substantial healthcare utilization. Risk factors included increased index colectomy complexity, while the laparoscopic approach was protective. Future research is needed to better identify high-risk patients and allow for appropriate economic and clinical risk adjustment of outcomes. Keywords: bowel obstruction, ileus, rehospitalization</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Colorectal surgery</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Adhesions</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Complications</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Medicine (General)</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Therapeutics. Pharmacology</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Sutton N</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Wei D</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Yoo A</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">In</subfield><subfield code="t">ClinicoEconomics and Outcomes Research</subfield><subfield code="d">Dove Medical Press, 2010</subfield><subfield code="g">(2018), Seite 761-771</subfield><subfield code="w">(DE-627)611725843</subfield><subfield code="w">(DE-600)2520698-9</subfield><subfield code="x">11786981</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">year:2018</subfield><subfield code="g">pages:761-771</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doaj.org/article/b336c1ea58204a2b86f23ffcd7a0f827</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://www.dovepress.com/impact-of-postcolectomy-adhesion-related-complications-on-healthcare-u-peer-reviewed-article-CEOR</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="2"><subfield code="u">https://doaj.org/toc/1178-6981</subfield><subfield code="y">Journal toc</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SYSFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_DOAJ</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_11</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_20</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_22</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_23</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_24</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_39</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_40</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_60</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_62</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_63</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_65</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_69</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_73</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_74</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_95</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_105</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_110</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_151</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_161</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_170</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_206</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_213</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_230</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_285</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_293</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_602</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2003</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2014</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4012</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4037</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4112</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4125</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4126</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4249</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4305</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4306</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4307</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4313</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4322</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4323</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4324</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4325</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4326</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4335</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4338</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4367</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4700</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="j">2018</subfield><subfield code="h">761-771</subfield></datafield></record></collection>
callnumber-first	R - Medicine
author	Etter K
spellingShingle	Etter K misc R5-920 misc RM1-950 misc Colorectal surgery misc Adhesions misc Complications misc Medicine (General) misc Therapeutics. Pharmacology Impact of postcolectomy adhesion-related complications on healthcare utilization
authorStr	Etter K
ppnlink_with_tag_str_mv	@@773@@(DE-627)611725843
format	electronic Article
delete_txt_mv	keep
author_role	aut aut aut aut
collection	DOAJ
remote_str	true
callnumber-label	R5-920
illustrated	Not Illustrated
issn	11786981
topic_title	R5-920 RM1-950 Impact of postcolectomy adhesion-related complications on healthcare utilization Colorectal surgery Adhesions Complications
topic	misc R5-920 misc RM1-950 misc Colorectal surgery misc Adhesions misc Complications misc Medicine (General) misc Therapeutics. Pharmacology
topic_unstemmed	misc R5-920 misc RM1-950 misc Colorectal surgery misc Adhesions misc Complications misc Medicine (General) misc Therapeutics. Pharmacology
topic_browse	misc R5-920 misc RM1-950 misc Colorectal surgery misc Adhesions misc Complications misc Medicine (General) misc Therapeutics. Pharmacology
format_facet	Elektronische Aufsätze Aufsätze Elektronische Ressource
format_main_str_mv	Text Zeitschrift/Artikel
carriertype_str_mv	cr
hierarchy_parent_title	ClinicoEconomics and Outcomes Research
hierarchy_parent_id	611725843
hierarchy_top_title	ClinicoEconomics and Outcomes Research
isfreeaccess_txt	true
familylinks_str_mv	(DE-627)611725843 (DE-600)2520698-9
title	Impact of postcolectomy adhesion-related complications on healthcare utilization
ctrlnum	(DE-627)DOAJ041710754 (DE-599)DOAJb336c1ea58204a2b86f23ffcd7a0f827
title_full	Impact of postcolectomy adhesion-related complications on healthcare utilization
author_sort	Etter K
journal	ClinicoEconomics and Outcomes Research
journalStr	ClinicoEconomics and Outcomes Research
callnumber-first-code	R
lang_code	eng
isOA_bool	true
recordtype	marc
publishDateSort	2018
contenttype_str_mv	txt
container_start_page	761
author_browse	Etter K Sutton N Wei D Yoo A
class	R5-920 RM1-950
format_se	Elektronische Aufsätze
author-letter	Etter K
author2-role	verfasserin
title_sort	impact of postcolectomy adhesion-related complications on healthcare utilization
callnumber	R5-920
title_auth	Impact of postcolectomy adhesion-related complications on healthcare utilization
abstract	Katherine Etter,1 Nadia Sutton,2 David Wei,3 Andrew Yoo3 1Medical Devices-Epidemiology, Johnson and Johnson, Raynham, MA 02767, USA; 2Ethicon HEMA, Somerville, NJ 08876, USA; 3Medical Devices-Epidemiology, Johnson and Johnson, New Brunswick, NJ 08901, USA Objective: The objective of this study was to explore adhesion-related complications (ARCs) within 1 year after colectomy.Methods: Using Truven MarketScan® Commercial and Medicare databases, the first inpatient colectomies during 2009–2013 (index) were identified: left, right, partial, transverse, or total. One-year continuous enrollment was required pre and postindex. Only the first inpatient rehospitalization event was analyzed. ARC was defined as the subset of rehospitalizations with a diagnosis of ileus, small bowel obstruction, or postindex adhesiolysis. ARC and non-ARC events were evaluated descriptively, including time to ARC, length of stay (LOS), and total hospitalization reimbursement (2015 US dollars [2015 USD]). Patient, provider, and procedure factors associated with ARC were explored using logistic regression models.Results: A total of 64,532 colectomies were identified: left (39.2%), right (34.9%), partial (20.0%), transverse (2.3%), and total (3.6%). Surgical approach was classified as open (60.1%) and laparoscopic (39.9%). All-cause first inpatient readmission incidence within 1 year was 24.7%, and ARC incidence was 5.7% in all patients or 23.2% in all first readmissions. ARC had statistically higher resource utilization compared to non-ARC with respective mean (SD) time to event (130 [102] and 137 [106] days), mean (SD) LOS (7.2 [8.0] and 5.2 [6.8] days), and mean (SD) total reimbursement ($29,802 [$43,037] and $22,476 [$36,130]). ARC risk factors included (OR [95% CI]) resection type (total vs right, 3.78 [3.27–4.36]), left vs right (1.69 [1.53–1.86]), adhesiolysis (2.45 [1.42–4.23]), computerized tomography (1.79 [1.65–1.95]), surgical indication: inflammatory bowel disease vs cancer (1.69 [1.43–1.99]), and multiple abdominal procedures (1.38 [1.29–1.49]). Laparoscopic approach was protective (0.42 [0.39–0.46]).Conclusion: ARCs were associated with almost one-fourth of all first rehospitalizations within the first year after colectomy and were associated with substantial healthcare utilization. Risk factors included increased index colectomy complexity, while the laparoscopic approach was protective. Future research is needed to better identify high-risk patients and allow for appropriate economic and clinical risk adjustment of outcomes. Keywords: bowel obstruction, ileus, rehospitalization
abstractGer	Katherine Etter,1 Nadia Sutton,2 David Wei,3 Andrew Yoo3 1Medical Devices-Epidemiology, Johnson and Johnson, Raynham, MA 02767, USA; 2Ethicon HEMA, Somerville, NJ 08876, USA; 3Medical Devices-Epidemiology, Johnson and Johnson, New Brunswick, NJ 08901, USA Objective: The objective of this study was to explore adhesion-related complications (ARCs) within 1 year after colectomy.Methods: Using Truven MarketScan® Commercial and Medicare databases, the first inpatient colectomies during 2009–2013 (index) were identified: left, right, partial, transverse, or total. One-year continuous enrollment was required pre and postindex. Only the first inpatient rehospitalization event was analyzed. ARC was defined as the subset of rehospitalizations with a diagnosis of ileus, small bowel obstruction, or postindex adhesiolysis. ARC and non-ARC events were evaluated descriptively, including time to ARC, length of stay (LOS), and total hospitalization reimbursement (2015 US dollars [2015 USD]). Patient, provider, and procedure factors associated with ARC were explored using logistic regression models.Results: A total of 64,532 colectomies were identified: left (39.2%), right (34.9%), partial (20.0%), transverse (2.3%), and total (3.6%). Surgical approach was classified as open (60.1%) and laparoscopic (39.9%). All-cause first inpatient readmission incidence within 1 year was 24.7%, and ARC incidence was 5.7% in all patients or 23.2% in all first readmissions. ARC had statistically higher resource utilization compared to non-ARC with respective mean (SD) time to event (130 [102] and 137 [106] days), mean (SD) LOS (7.2 [8.0] and 5.2 [6.8] days), and mean (SD) total reimbursement ($29,802 [$43,037] and $22,476 [$36,130]). ARC risk factors included (OR [95% CI]) resection type (total vs right, 3.78 [3.27–4.36]), left vs right (1.69 [1.53–1.86]), adhesiolysis (2.45 [1.42–4.23]), computerized tomography (1.79 [1.65–1.95]), surgical indication: inflammatory bowel disease vs cancer (1.69 [1.43–1.99]), and multiple abdominal procedures (1.38 [1.29–1.49]). Laparoscopic approach was protective (0.42 [0.39–0.46]).Conclusion: ARCs were associated with almost one-fourth of all first rehospitalizations within the first year after colectomy and were associated with substantial healthcare utilization. Risk factors included increased index colectomy complexity, while the laparoscopic approach was protective. Future research is needed to better identify high-risk patients and allow for appropriate economic and clinical risk adjustment of outcomes. Keywords: bowel obstruction, ileus, rehospitalization
abstract_unstemmed	Katherine Etter,1 Nadia Sutton,2 David Wei,3 Andrew Yoo3 1Medical Devices-Epidemiology, Johnson and Johnson, Raynham, MA 02767, USA; 2Ethicon HEMA, Somerville, NJ 08876, USA; 3Medical Devices-Epidemiology, Johnson and Johnson, New Brunswick, NJ 08901, USA Objective: The objective of this study was to explore adhesion-related complications (ARCs) within 1 year after colectomy.Methods: Using Truven MarketScan® Commercial and Medicare databases, the first inpatient colectomies during 2009–2013 (index) were identified: left, right, partial, transverse, or total. One-year continuous enrollment was required pre and postindex. Only the first inpatient rehospitalization event was analyzed. ARC was defined as the subset of rehospitalizations with a diagnosis of ileus, small bowel obstruction, or postindex adhesiolysis. ARC and non-ARC events were evaluated descriptively, including time to ARC, length of stay (LOS), and total hospitalization reimbursement (2015 US dollars [2015 USD]). Patient, provider, and procedure factors associated with ARC were explored using logistic regression models.Results: A total of 64,532 colectomies were identified: left (39.2%), right (34.9%), partial (20.0%), transverse (2.3%), and total (3.6%). Surgical approach was classified as open (60.1%) and laparoscopic (39.9%). All-cause first inpatient readmission incidence within 1 year was 24.7%, and ARC incidence was 5.7% in all patients or 23.2% in all first readmissions. ARC had statistically higher resource utilization compared to non-ARC with respective mean (SD) time to event (130 [102] and 137 [106] days), mean (SD) LOS (7.2 [8.0] and 5.2 [6.8] days), and mean (SD) total reimbursement ($29,802 [$43,037] and $22,476 [$36,130]). ARC risk factors included (OR [95% CI]) resection type (total vs right, 3.78 [3.27–4.36]), left vs right (1.69 [1.53–1.86]), adhesiolysis (2.45 [1.42–4.23]), computerized tomography (1.79 [1.65–1.95]), surgical indication: inflammatory bowel disease vs cancer (1.69 [1.43–1.99]), and multiple abdominal procedures (1.38 [1.29–1.49]). Laparoscopic approach was protective (0.42 [0.39–0.46]).Conclusion: ARCs were associated with almost one-fourth of all first rehospitalizations within the first year after colectomy and were associated with substantial healthcare utilization. Risk factors included increased index colectomy complexity, while the laparoscopic approach was protective. Future research is needed to better identify high-risk patients and allow for appropriate economic and clinical risk adjustment of outcomes. Keywords: bowel obstruction, ileus, rehospitalization
collection_details	GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700
title_short	Impact of postcolectomy adhesion-related complications on healthcare utilization
url	https://doaj.org/article/b336c1ea58204a2b86f23ffcd7a0f827 https://www.dovepress.com/impact-of-postcolectomy-adhesion-related-complications-on-healthcare-u-peer-reviewed-article-CEOR https://doaj.org/toc/1178-6981
remote_bool	true
author2	Sutton N Wei D Yoo A
author2Str	Sutton N Wei D Yoo A
ppnlink	611725843
callnumber-subject	R - General Medicine
mediatype_str_mv	c
isOA_txt	true
hochschulschrift_bool	false
callnumber-a	R5-920
up_date	2024-07-03T21:43:52.940Z
_version_	1803595843310190592
fullrecord_marcxml	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">DOAJ041710754</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230308052027.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230227s2018 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ041710754</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJb336c1ea58204a2b86f23ffcd7a0f827</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">R5-920</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RM1-950</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">Etter K</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Impact of postcolectomy adhesion-related complications on healthcare utilization</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2018</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Katherine Etter,1 Nadia Sutton,2 David Wei,3 Andrew Yoo3 1Medical Devices-Epidemiology, Johnson and Johnson, Raynham, MA 02767, USA; 2Ethicon HEMA, Somerville, NJ 08876, USA; 3Medical Devices-Epidemiology, Johnson and Johnson, New Brunswick, NJ 08901, USA Objective: The objective of this study was to explore adhesion-related complications (ARCs) within 1 year after colectomy.Methods: Using Truven MarketScan&reg; Commercial and Medicare databases, the first inpatient colectomies during 2009&ndash;2013 (index) were identified: left, right, partial, transverse, or total. One-year continuous enrollment was required pre and postindex. Only the first inpatient rehospitalization event was analyzed. ARC was defined as the subset of rehospitalizations with a diagnosis of ileus, small bowel obstruction, or postindex adhesiolysis. ARC and non-ARC events were evaluated descriptively, including time to ARC, length of stay (LOS), and total hospitalization reimbursement (2015 US dollars [2015 USD]). Patient, provider, and procedure factors associated with ARC were explored using logistic regression models.Results: A total of 64,532 colectomies were identified: left (39.2%), right (34.9%), partial (20.0%), transverse (2.3%), and total (3.6%). Surgical approach was classified as open (60.1%) and laparoscopic (39.9%). All-cause first inpatient readmission incidence within 1 year was 24.7%, and ARC incidence was 5.7% in all patients or 23.2% in all first readmissions. ARC had statistically higher resource utilization compared to non-ARC with respective mean (SD) time to event (130 [102] and 137 [106] days), mean (SD) LOS (7.2 [8.0] and 5.2 [6.8] days), and mean (SD) total reimbursement ($29,802 [$43,037] and $22,476 [$36,130]). ARC risk factors included (OR [95% CI]) resection type (total vs right, 3.78 [3.27&ndash;4.36]), left vs right (1.69 [1.53&ndash;1.86]), adhesiolysis (2.45 [1.42&ndash;4.23]), computerized tomography (1.79 [1.65&ndash;1.95]), surgical indication: inflammatory bowel disease vs cancer (1.69 [1.43&ndash;1.99]), and multiple abdominal procedures (1.38 [1.29&ndash;1.49]). Laparoscopic approach was protective (0.42 [0.39&ndash;0.46]).Conclusion: ARCs were associated with almost one-fourth of all first rehospitalizations within the first year after colectomy and were associated with substantial healthcare utilization. Risk factors included increased index colectomy complexity, while the laparoscopic approach was protective. Future research is needed to better identify high-risk patients and allow for appropriate economic and clinical risk adjustment of outcomes. Keywords: bowel obstruction, ileus, rehospitalization</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Colorectal surgery</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Adhesions</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Complications</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Medicine (General)</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Therapeutics. Pharmacology</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Sutton N</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Wei D</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Yoo A</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">In</subfield><subfield code="t">ClinicoEconomics and Outcomes Research</subfield><subfield code="d">Dove Medical Press, 2010</subfield><subfield code="g">(2018), Seite 761-771</subfield><subfield code="w">(DE-627)611725843</subfield><subfield code="w">(DE-600)2520698-9</subfield><subfield code="x">11786981</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">year:2018</subfield><subfield code="g">pages:761-771</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doaj.org/article/b336c1ea58204a2b86f23ffcd7a0f827</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://www.dovepress.com/impact-of-postcolectomy-adhesion-related-complications-on-healthcare-u-peer-reviewed-article-CEOR</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="2"><subfield code="u">https://doaj.org/toc/1178-6981</subfield><subfield code="y">Journal toc</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SYSFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_DOAJ</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_11</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_20</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_22</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_23</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_24</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_39</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_40</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_60</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_62</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_63</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_65</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_69</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_73</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_74</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_95</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_105</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_110</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_151</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_161</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_170</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_206</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_213</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_230</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_285</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_293</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_602</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2003</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_2014</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4012</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4037</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4112</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4125</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4126</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4249</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4305</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4306</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4307</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4313</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4322</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4323</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4324</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4325</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4326</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4335</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4338</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4367</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_ILN_4700</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="j">2018</subfield><subfield code="h">761-771</subfield></datafield></record></collection>
score	7.4021244

Nicht das Richtige dabei?

Schreiben Sie uns!

Impact of postcolectomy adhesion-related complications on healthcare utilization

Nicht das Richtige dabei?

Zugang & Verfügbarkeit

Vorhandene Bände

Nicht das Richtige dabei?