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.
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: C K Liu; X Leng; F-C Hsu; S B Kritchevsky; J Ding; C P Earnest; L Ferrucci; B H Goodpaster; J M Guralnik; L Lenchik; M Pahor; R A Fielding Journal: J Nutr Health Aging Date: 2014-01 Impact factor: 4.075
Authors: Jay Soong-Jin Lee; Kevin He; Calista M Harbaugh; Douglas E Schaubel; Christopher J Sonnenday; Stewart C Wang; Michael J Englesbe; Jonathan L Eliason Journal: J Vasc Surg Date: 2011-01-07 Impact factor: 4.268
Authors: Thomas J Hoogeboom; Jaap J Dronkers; Cornelia H M van den Ende; Ellen Oosting; Nico L U van Meeteren Journal: Clin Rehabil Date: 2010-06-16 Impact factor: 3.477
Authors: Pratima Sharma; Neehar D Parikh; Jessica Yu; Pranab Barman; Brian A Derstine; Christopher J Sonnenday; Stewart C Wang; Grace L Su Journal: Liver Transpl Date: 2016-06-29 Impact factor: 5.799
Authors: Christine M Leeper; Elizabeth Lin; Marcus Hoffman; Anisleidy Fombona; Tianhua Zhou; Matthew Kutcher; Matthew Rosengart; Gregory Watson; Timothy Billiar; Andrew Peitzman; Brian Zuckerbraun; Jason Sperry Journal: J Trauma Acute Care Surg Date: 2016-05 Impact factor: 3.313
Authors: Toby L Chambers; Timothy R Burnett; Ulrika Raue; Gary A Lee; W Holmes Finch; Bruce M Graham; Todd A Trappe; Scott Trappe Journal: J Appl Physiol (1985) Date: 2019-12-12
Authors: Jeroen L A van Vugt; Stefan Buettner; Stef Levolger; Robert R J Coebergh van den Braak; Mustafa Suker; Marcia P Gaspersz; Ron W F de Bruin; Cornelis Verhoef; Casper H C van Eijck; Niek Bossche; Bas Groot Koerkamp; Jan N M IJzermans Journal: PLoS One Date: 2017-10-31 Impact factor: 3.240
Authors: D M Mijnarends; Y C Luiking; R J G Halfens; S M A A Evers; E L A Lenaerts; S Verlaan; M Wallace; J M G A Schols; J M M Meijers Journal: J Nutr Health Aging Date: 2018 Impact factor: 4.075
Authors: S T Clark; G Malietzis; T N Grove; J T Jenkins; A C J Windsor; C Kontovounisios; O J Warren Journal: Hernia Date: 2020-04-16 Impact factor: 4.739