Sarcopenia predicts costs among patients undergoing major abdominal operations

Faiz Gani, Stefan Buettner, Georgios A. Margonis, Kazunari Sasaki, Doris Wagner, Yuhree Kim, John Hundt, Ihab R Kamel, Timothy M. Pawlik

Research output: Contribution to journalArticle

Abstract

Background Although sarcopenia has been identified as a predictor of poor, postoperative, clinical outcomes, the financial impact of sarcopenia remains undetermined. We sought to evaluate the relationship between sarcopenia and hospital finances among a cohort of patients undergoing a hepato-pancreatico-biliary or colorectal resection. Methods Clinical, financial, and morphometric data were collected for 1,169 patients undergoing operative resection between January 2011 and December 2013 at the Johns Hopkins Hospital. Multivariable regression analysis was performed to assess the relationship between sarcopenia and total hospital costs. Results Using sex-specific cutoffs for total psoas volume, 293 patients were categorized as sarcopenic. The presence of sarcopenia was associated with a $14,322 increase in the total hospital cost (median covariate-adjusted cost, sarcopenia versus no sarcopenia: $38,804 vs $24,482, P < .001). Patients who presented with sarcopenia demonstrated a higher total hospital cost within the subgroup of patients who developed a postoperative complication (sarcopenia versus no sarcopenia: $65,856 vs $59,609) and among those patients who did not develop a postoperative complication (sarcopenia versus no sarcopenia: $26,282 vs $23,763, both P < .001). Similarly, total hospital costs were higher among patients presenting with sarcopenia regardless of the length of stay for index admission (observed:expected, length of stay < 1: sarcopenia versus no sarcopenia: $25,038 vs $22,827; observed:expected, length of stay > 1: sarcopenia versus no sarcopenia: $43,283 vs $38,679, both P < .001). Conclusion As measured by sarcopenia, patient frailty is inversely related to total hospital costs. Sarcopenia represents a novel tool for forecasting patient outcomes and operative costs and can be used to inform quality improvement and cost containment strategies.

Original languageEnglish (US)
Pages (from-to)1162-1171
Number of pages10
JournalSurgery
Volume160
Issue number5
DOIs
StatePublished - Nov 1 2016

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Sarcopenia
Costs and Cost Analysis
Hospital Costs
Cost Control
Quality Improvement

ASJC Scopus subject areas

  • Surgery

Cite this

Gani, F., Buettner, S., Margonis, G. A., Sasaki, K., Wagner, D., Kim, Y., ... Pawlik, T. M. (2016). Sarcopenia predicts costs among patients undergoing major abdominal operations. Surgery, 160(5), 1162-1171. https://doi.org/10.1016/j.surg.2016.05.002

Sarcopenia predicts costs among patients undergoing major abdominal operations. / Gani, Faiz; Buettner, Stefan; Margonis, Georgios A.; Sasaki, Kazunari; Wagner, Doris; Kim, Yuhree; Hundt, John; Kamel, Ihab R; Pawlik, Timothy M.

In: Surgery, Vol. 160, No. 5, 01.11.2016, p. 1162-1171.

Research output: Contribution to journalArticle

Gani, F, Buettner, S, Margonis, GA, Sasaki, K, Wagner, D, Kim, Y, Hundt, J, Kamel, IR & Pawlik, TM 2016, 'Sarcopenia predicts costs among patients undergoing major abdominal operations', Surgery, vol. 160, no. 5, pp. 1162-1171. https://doi.org/10.1016/j.surg.2016.05.002
Gani F, Buettner S, Margonis GA, Sasaki K, Wagner D, Kim Y et al. Sarcopenia predicts costs among patients undergoing major abdominal operations. Surgery. 2016 Nov 1;160(5):1162-1171. https://doi.org/10.1016/j.surg.2016.05.002
Gani, Faiz ; Buettner, Stefan ; Margonis, Georgios A. ; Sasaki, Kazunari ; Wagner, Doris ; Kim, Yuhree ; Hundt, John ; Kamel, Ihab R ; Pawlik, Timothy M. / Sarcopenia predicts costs among patients undergoing major abdominal operations. In: Surgery. 2016 ; Vol. 160, No. 5. pp. 1162-1171.
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AU - Gani, Faiz

AU - Buettner, Stefan

AU - Margonis, Georgios A.

AU - Sasaki, Kazunari

AU - Wagner, Doris

AU - Kim, Yuhree

AU - Hundt, John

AU - Kamel, Ihab R

AU - Pawlik, Timothy M.

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AB - Background Although sarcopenia has been identified as a predictor of poor, postoperative, clinical outcomes, the financial impact of sarcopenia remains undetermined. We sought to evaluate the relationship between sarcopenia and hospital finances among a cohort of patients undergoing a hepato-pancreatico-biliary or colorectal resection. Methods Clinical, financial, and morphometric data were collected for 1,169 patients undergoing operative resection between January 2011 and December 2013 at the Johns Hopkins Hospital. Multivariable regression analysis was performed to assess the relationship between sarcopenia and total hospital costs. Results Using sex-specific cutoffs for total psoas volume, 293 patients were categorized as sarcopenic. The presence of sarcopenia was associated with a $14,322 increase in the total hospital cost (median covariate-adjusted cost, sarcopenia versus no sarcopenia: $38,804 vs $24,482, P < .001). Patients who presented with sarcopenia demonstrated a higher total hospital cost within the subgroup of patients who developed a postoperative complication (sarcopenia versus no sarcopenia: $65,856 vs $59,609) and among those patients who did not develop a postoperative complication (sarcopenia versus no sarcopenia: $26,282 vs $23,763, both P < .001). Similarly, total hospital costs were higher among patients presenting with sarcopenia regardless of the length of stay for index admission (observed:expected, length of stay < 1: sarcopenia versus no sarcopenia: $25,038 vs $22,827; observed:expected, length of stay > 1: sarcopenia versus no sarcopenia: $43,283 vs $38,679, both P < .001). Conclusion As measured by sarcopenia, patient frailty is inversely related to total hospital costs. Sarcopenia represents a novel tool for forecasting patient outcomes and operative costs and can be used to inform quality improvement and cost containment strategies.

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