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Published in: BMC Surgery 1/2011

Open Access 01-12-2011 | Research article

The inpatient burden of abdominal and gynecological adhesiolysis in the US

Authors: Vanja Sikirica, Bela Bapat, Sean D Candrilli, Keith L Davis, Malcolm Wilson, Alan Johns

Published in: BMC Surgery | Issue 1/2011

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Abstract

Background

Adhesions are fibrous bands of scar tissue, often a result of surgery, that form between internal organs and tissues, joining them together abnormally. Postoperative adhesions frequently occur following abdominal surgery, and are associated with a large economic burden. This study examines the inpatient burden of adhesiolysis in the United States (i.e., number and rate of events, cost, length of stay [LOS]).

Methods

Hospital discharge data for patients with primary and secondary adhesiolysis were analyzed using the 2005 Healthcare Cost and Utilization Project's Nationwide Inpatient Sample. Procedures were aggregated by body system.

Results

We identified 351,777 adhesiolysis-related hospitalizations: 23.2% for primary and 76.8% for secondary adhesiolysis. The average LOS was 7.8 days for primary adhesiolysis. We found that 967,332 days of care were attributed to adhesiolysis-related procedures, with inpatient expenditures totaling $2.3 billion ($1.4 billion for primary adhesiolysis; $926 million for secondary adhesiolysis). Hospitalizations for adhesiolysis increased steadily by age and were higher for women. Of secondary adhesiolysis procedures, 46.3% involved the female reproductive tract, resulting in 57,005 additional days of care and $220 million in attributable costs.

Conclusions

Adhesiolysis remain an important surgical problem in the United States. Hospitalization for this condition leads to high direct surgical costs, which should be of interest to providers and payers.
Literature
1.
go back to reference Beck DE: Understanding abdominal adhesions. Ostomy Q. 2001, 38 (2): 50-51. Beck DE: Understanding abdominal adhesions. Ostomy Q. 2001, 38 (2): 50-51.
2.
go back to reference Ray NF, Denton WG, Thamer M, Henderson SC, Perry S: Abdominal adhesiolysis: inpatient care and expenditures in the United States in 1994. J Am Coll Surg. 1998, 186 (1): 1-9. 10.1016/S1072-7515(97)00127-0.CrossRefPubMed Ray NF, Denton WG, Thamer M, Henderson SC, Perry S: Abdominal adhesiolysis: inpatient care and expenditures in the United States in 1994. J Am Coll Surg. 1998, 186 (1): 1-9. 10.1016/S1072-7515(97)00127-0.CrossRefPubMed
3.
go back to reference Menzies D, Parker M, Hoare R, Knight A: Small bowel obstruction due to postoperative adhesions: treatment patterns and associated costs in 110 hospital admissions. Ann R Coll Surg Engl. 2001, 83: 40-46.PubMedPubMedCentral Menzies D, Parker M, Hoare R, Knight A: Small bowel obstruction due to postoperative adhesions: treatment patterns and associated costs in 110 hospital admissions. Ann R Coll Surg Engl. 2001, 83: 40-46.PubMedPubMedCentral
4.
go back to reference diZerega GS, Tulandi T: Prevention of intra-abdominal adhesions in gynaecological surgery. Reprod Biomed Online. 2008, 17: 303-306. 10.1016/S1472-6483(10)60211-8.CrossRefPubMed diZerega GS, Tulandi T: Prevention of intra-abdominal adhesions in gynaecological surgery. Reprod Biomed Online. 2008, 17: 303-306. 10.1016/S1472-6483(10)60211-8.CrossRefPubMed
5.
go back to reference Tingstedt B, Isaksson J, Andersson R: Long-term follow-up and costs analysis following surgery for small bowel obstruction caused by intra-abdominal adhesions. Br J Surg. 2007, 94: 743-748. 10.1002/bjs.5634.CrossRefPubMed Tingstedt B, Isaksson J, Andersson R: Long-term follow-up and costs analysis following surgery for small bowel obstruction caused by intra-abdominal adhesions. Br J Surg. 2007, 94: 743-748. 10.1002/bjs.5634.CrossRefPubMed
6.
go back to reference Ellis H, Moran BJ, Thompson JN, Parker MC, Wilson MS, Menzies D, McGuire A, Lower AM, Hawthorn RJ, O'Brien F, Buchan S, Crowe AM: Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study. Lancet. 1999, 353: 1476-1480. 10.1016/S0140-6736(98)09337-4.CrossRefPubMed Ellis H, Moran BJ, Thompson JN, Parker MC, Wilson MS, Menzies D, McGuire A, Lower AM, Hawthorn RJ, O'Brien F, Buchan S, Crowe AM: Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study. Lancet. 1999, 353: 1476-1480. 10.1016/S0140-6736(98)09337-4.CrossRefPubMed
7.
go back to reference Parker MC, Ellis H, Moran BJ, Thompson JN, Wilson MS, Menzies D, McGuire A, Lower AM, Hawthorn RJ, O'Briena F, Buchan S, Crowe AM: Postoperative adhesions: ten-year follow-up of 12,584 patients undergoing lower abdominal surgery. Dis Colon Rectum. 2001, 44: 822-829. 10.1007/BF02234701.CrossRefPubMed Parker MC, Ellis H, Moran BJ, Thompson JN, Wilson MS, Menzies D, McGuire A, Lower AM, Hawthorn RJ, O'Briena F, Buchan S, Crowe AM: Postoperative adhesions: ten-year follow-up of 12,584 patients undergoing lower abdominal surgery. Dis Colon Rectum. 2001, 44: 822-829. 10.1007/BF02234701.CrossRefPubMed
8.
go back to reference Lower AM, Hawthorn RJ, Ellis H, O'Brien F, Buchan S, Crowe AM: The impact of adhesions on hospital readmissions over ten years after 8489 open gynaecological operations: an assessment from the Surgical and Clinical Adhesions Research Study. Br J Obstet Gynaecol. 2000, 107: 855-862. 10.1111/j.1471-0528.2000.tb11083.x.CrossRef Lower AM, Hawthorn RJ, Ellis H, O'Brien F, Buchan S, Crowe AM: The impact of adhesions on hospital readmissions over ten years after 8489 open gynaecological operations: an assessment from the Surgical and Clinical Adhesions Research Study. Br J Obstet Gynaecol. 2000, 107: 855-862. 10.1111/j.1471-0528.2000.tb11083.x.CrossRef
9.
go back to reference Meagher AP, Moller C, Hoffmann DC: Non-operative treatment of small bowel obstruction following appendectomy or operation on the ovary or tube. Br J Surg. 1993, 80: 1310-1311. 10.1002/bjs.1800801030.CrossRefPubMed Meagher AP, Moller C, Hoffmann DC: Non-operative treatment of small bowel obstruction following appendectomy or operation on the ovary or tube. Br J Surg. 1993, 80: 1310-1311. 10.1002/bjs.1800801030.CrossRefPubMed
10.
go back to reference Ray NF, Larsen JW, Stillman RJ, Jacobs RJ: Economic impact of hospitalizations for lower abdominal adhesiolysis in the United States in 1988. Surg Gynecol Obstet. 1993, 176: 271-276.PubMed Ray NF, Larsen JW, Stillman RJ, Jacobs RJ: Economic impact of hospitalizations for lower abdominal adhesiolysis in the United States in 1988. Surg Gynecol Obstet. 1993, 176: 271-276.PubMed
12.
go back to reference Steiner C, Elixhauser A, Schnaier J: The Healthcare Cost and Utilization Project: an overview. Eff Clin Pract. 2002, 5 (3): 143-151.PubMed Steiner C, Elixhauser A, Schnaier J: The Healthcare Cost and Utilization Project: an overview. Eff Clin Pract. 2002, 5 (3): 143-151.PubMed
14.
go back to reference SAS Institute Inc: SAS 9.1.3. 2003, Cary, NC: SAS Institute Inc SAS Institute Inc: SAS 9.1.3. 2003, Cary, NC: SAS Institute Inc
15.
go back to reference Research Triangle Institute: SUDAAN (Release 9.0.1). 2005, Research Triangle Park, NC: Research Triangle Institute Research Triangle Institute: SUDAAN (Release 9.0.1). 2005, Research Triangle Park, NC: Research Triangle Institute
16.
go back to reference Gutt CN, Oniu T, Schemmer P, Mehrabi A, Büchler MW: Fewer adhesions induced by laparoscopic surgery?. Surg Endosc. 2004, 18 (6): 898-906. 10.1007/s00464-003-9233-3.CrossRefPubMed Gutt CN, Oniu T, Schemmer P, Mehrabi A, Büchler MW: Fewer adhesions induced by laparoscopic surgery?. Surg Endosc. 2004, 18 (6): 898-906. 10.1007/s00464-003-9233-3.CrossRefPubMed
17.
go back to reference Parker MC, Wilson MS, Menzies D, Sunderland G, Clark DN, Knight AD, Crowe AM, Surgical and Clinical Adhesions Research (SCAR) Group: The SCAR-3 study: 5-year adhesion-related readmission risk following lower abdominal surgical procedures. Colorectal Dis. 2005, 7: 551-558. 10.1111/j.1463-1318.2005.00857.x.CrossRefPubMed Parker MC, Wilson MS, Menzies D, Sunderland G, Clark DN, Knight AD, Crowe AM, Surgical and Clinical Adhesions Research (SCAR) Group: The SCAR-3 study: 5-year adhesion-related readmission risk following lower abdominal surgical procedures. Colorectal Dis. 2005, 7: 551-558. 10.1111/j.1463-1318.2005.00857.x.CrossRefPubMed
Metadata
Title
The inpatient burden of abdominal and gynecological adhesiolysis in the US
Authors
Vanja Sikirica
Bela Bapat
Sean D Candrilli
Keith L Davis
Malcolm Wilson
Alan Johns
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2011
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/1471-2482-11-13

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