Table 3.
Risk-adjusted predicted mean incremental complication costs (95%CI) in 2017 USDA,B (independent of other included complications)
| Cost of Major Oncologic Resections for Corresponding Malignant Diagnosis | |||||
|---|---|---|---|---|---|
| No complication | Any complication | Mechanical wound | Infection | Urinary | |
| (base value) | (incremental cost) | (incremental cost) | (incremental cost) | (incremental cost) | |
| Esophagus | $41,965.52 ($39,600-44,400) |
$40,373.00 ($37,400-43,400) p<0.001 |
$24,567.81 ($19,900-29,300) p<0.001 |
$46,583.13 ($42,100-51,100) p<0.001 |
$10,137.61 ($0-23,600) p=0.140 |
| Stomach | $31,294.51 ($30,400-32,200) |
$34,327.54 ($32,400-36,300) p<0.001 |
$18,974.45 ($15,700-22,300) p<0.001 |
$32,655.44 ($30,600-34,700) p<0.001 |
$3,270.68 ($0-7,000) p=0.087 |
| Colon | $19,134.92 ($18,900-19,400) |
$15,486.34 ($15,100-15,900) p<0.001 |
$11,810.92 ($11,100-12,500) p<0.001 |
$17,452.93 ($17,000-17,900) p<0.001 |
$3,124.35 ($2,400-3,800) p<0.001 |
| Liver | $24,545.76 ($23,600-25,500) |
$28,084.65 ($25,800-30,400) p<0.001 |
$14,039.63 ($10,700-17,400) p<0.001 |
$26,998.96 ($24,600-29,400) p<0.001 |
$8,028.56 ($3,500-12,500) p<0.001 |
| Pancreas | $34,948.59 ($33,700-36,100) |
$29,955.04 $28,100-31,800) p<0.001 |
$16,828.88 ($13,700-20,000) p<0.001 |
$29,338.55 ($27,100-31,600) p<0.001 |
$8,630.08 ($3,600-13,600) p=0.001 |
| Rectum | $22,389.27 ($21,700-23,000) |
$12,738.36 ($10,700-14,700) p<0.001 |
$10.458.97 ($6,900-14,100) p<0.001 |
$14,209.97 ($11,400-17,000) p<0.001 |
$1,219.58 ($0-4,600) p=0.474 |
|
All operations |
$21,438.63 ($21,000-21,700) |
$20,889.63 ($20,300-21,500) p<0.001 |
$13,632.87 ($12,900-14,300) p<0.001 |
$21,640.12 ($21,000-22,200) p<0.001 |
$3,514.51 ($2,700-4,400) p<0.001 |
| Pulmonary | Gastrointestinal | Cardiovascular | Systemic | Surgical | |
| (incremental cost) | (incremental cost) | (incremental cost) | (incremental cost) | (incremental cost) | |
| Esophagus | $21,744.40 ($18,600-24,900) p<0.001 |
$18,521.98 ($14,800-22,300) p<0.001 |
$9,376.70 ($6,000-12,700) p=0.001 |
$13,293.32 ($3,400-23,200) p=0.009 |
$10,733.90 ($6,500-15,000) p<0.001 |
| Stomach | $21,393.14 ($19,700-23,100) p<0.001 |
$14,798.45 ($13,100-16,500) p<0.001 |
$11,201.20 ($9,100-13,300) p<0.001 |
$8,730.07 ($5,500-11,900) p<0.001 |
$9,410.60 ($7,200-11,600) p<0.001 |
| Colon | $11,890.64 ($11,400-12,400) p<0.001 |
$5,958.92 ($5,700-6,300) p<0.001 |
$7,778.60 ($7,300-8,300) p<0.001 |
$4,699.68 ($3,800-5,600) p<0.001 |
$6,823.41 ($6,300-7,300) p<0.001 |
| Liver | $17,749.46 ($15,100-20.400) p<0.001 |
$9,207.44 ($7,600-10,800) p<0.001 |
$9,334.82 ($7,100-11,600) p<0.001 |
$3,805.61 ($100-7,600) p=0.048 |
$14,062.81 ($11,500-16,600) p<0.001 |
| Pancreas | $18,494.55 ($16,100-20,900) p<0.001 |
$10,733.72 ($8,900-12,600) p<0.001 |
$9,509.78 ($6,900-12,100) p<0.001 |
$3,858.17 ($0-8,000) p=0.068 |
$15,148.29 ($12,800-17,500) p<0.001 |
| Rectum | $4,870.77 ($1,100-8,700) p=0.012 |
$5,575.90 ($3,900-7,300) p<0.001 |
$10,375.04 ($4,100-16,600) p=0.001 |
$2,878.68 ($0-11,600) p=0.517 |
$8.094.11 ($4,700-11,500) p<0.001 |
|
All operations |
$16,809.14 ($16,200-17,400) p<0.001 |
$6,713.84 ($6,300-10,300) p<0.001 |
$9,733.42 ($9,200-10,300) p<0.001 |
$6,326.87 ($5,400-7,300) p<0.001 |
$9,009.16 (8,500-9,500) p<0.001 |
Models accounted for potential confounding due to patient characteristics (age, sex, race/ethnicity, insurance type, median income quartile, indication, primary diagnosis, CCI, and year) and hospital-level factors (hospital volume, teaching-location, and geographical region). Calculation of incremental additions also accounted for the potential influence of multiple complications by adjusting for the occurrence of all other complications to yield isolated, complication-specific effects.
Modeling used NIS-provided population weights generalized with STATA’s “svy” command to account for patient clustering within hospital-level variables and to extrapolate the sample to a nationally representative version of the US population. Predicted mean differences were calculated using post-estimation marginal effects following GLM with link log, family gamma, to account for the highly-skewed nature of the data.