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Increased hospital costs are associated with low skeletal muscle mass in patients undergoing elective open aortic surgery.

Abstract：

OBJECTIVE:Low psoas muscle area is shown to be an indicator for worse postoperative outcome in patients undergoing vascular surgical. Additionally, it has been associated with longer durations of hospital stay in patients with cancer who undergo surgery and subsequently greater health care costs in Europe and the United States. We sought to evaluate this effect on hospital expenditure for patients undergoing vascular repair in a health care system with universal access. METHODS:Skeletal muscle mass was assessed on preoperative abdominal computed tomography scans of patients undergoing open aortic aneurysm repair in a retrospective fashion. The skeletal muscle index (SMI) was used to define low muscle mass. Health care costs were obtained for all patients and the relationship between a low SMI and higher costs was explored using linear regression and cross-sectional analysis. RESULTS:We included 156 patients (81.5% male) with a median age of 72 years undergoing elective surgery for infrarenal abdominal aortic aneurysm in this analysis. The median SMI for patients with low skeletal muscle mass was 53.21 cm2/kg and for patients without, 70.07 cm2/kg. Hospital duration of stay was 2 days longer in patients with low skeletal muscle mass as compared with patients with normal (14 days vs 11 days; P = .001), as was duration of intensive care stay (3 days vs 1 day; P = .01). The median overall hospital costs were €10,460 higher for patients with a low SMI as compared with patients with a normal physical constitution (€53,739 [interquartile range, €45,007-€62,471] vs €43,279 [interquartile range, €39,509-€47,049]; P = .001). After confounder adjustment, a low SMI was associated with a 14.68% cost increase in overall hospital costs, for a cost increase of €6521. CONCLUSIONS:Low skeletal muscle mass is independently associated with higher hospital as well as intensive care costs in patients undergoing elective aortic aneurysm repair. Strategies to reduce this risk factor are warranted for these patients.

journal_name

J Vasc Surg

journal_title

Journal of vascular surgery

authors

Koter S,Cohnert TU,Hindermayr KB,Lindenmann J,Brückner M,Oswald WK,Werkgartner G,Wagner D

doi

10.1016/j.jvs.2018.06.224

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

1227-1232

issue

eissn

0741-5214

issn

1097-6809

pii

S0741-5214(18)32072-X

journal_volume

pub_type

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Increased hospital costs are associated with low skeletal muscle mass in patients undergoing elective open aortic surgery.