Surgical Site Infections and their economic significance in hepatopancreatobiliary surgery: A retrospective incidence, cost, and reimbursement analysis in a German centre of the highest level of care

Brennfleck, Frank; Bachmeier, Tanja; Simet, Wolfgang; Zeman, Florian; Junger, Henrik; Dahlke, Marc-Hendrik; Brunner, Stefan M.

doi:10.1111/iwj.13511

Cited by 7 publications

(7 citation statements)

References 15 publications

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“…Furthermore, we did not include outpatient costs pre-admission and after discharge, as not all costs incur to the treating hospital but can be covered by other outpatient providers, limiting the comparability. Finally, diagnosing and classifying postoperative complications is encouraged as this can lead to a case being classified as being “more complex” and hence again generating more profit [ 23 , 24 ]. However, we saw negative profit margins in cases of severe complications and no adequate reimbursement for such complex cases.…”

Section: Discussionmentioning

confidence: 99%

From morbidity reduction to cost-effectiveness: Enhanced recovery after surgery (ERAS) society recommendations in minimal invasive liver surgery

Moosburner,

Dahlke,

Neudecker

et al. 2024

Langenbecks Arch Surg

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Purpose Minimal-invasive liver surgery (MILS) reduces surgical trauma and is associated with fewer postoperative complications. To amplify these benefits, perioperative multimodal concepts like Enhanced Recovery after Surgery (ERAS), can play a crucial role. We aimed to evaluate the cost-effectiveness for MILS in an ERAS program, considering the necessary additional workforce and associated expenses. Methods A prospective observational study comparing surgical approach in patients within an ERAS program compared to standard care from 2018—2022 at the Charité – Universitätsmedizin Berlin. Cost data were provided by the medical controlling office. ERAS items were applied according to the ERAS society recommendations. Results 537 patients underwent liver surgery (46% laparoscopic, 26% robotic assisted, 28% open surgery) and 487 were managed by the ERAS protocol. Implementation of ERAS reduced overall postoperative complications in the MILS group (18% vs. 32%, p = 0.048). Complications greater than Clavien-Dindo grade II incurred the highest costs (€ 31,093) compared to minor (€ 17,510) and no complications (€13,893; p < 0.001). In the event of major complications, profit margins were reduced by a median of € 6,640. Conclusions Embracing the ERAS society recommendations in liver surgery leads to a significant reduction of complications. This outcome justifies the higher cost associated with a well-structured ERAS protocol, as it effectively offsets the expenses of complications.

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Section: Discussionmentioning

confidence: 99%

From morbidity reduction to cost-effectiveness: Enhanced recovery after surgery (ERAS) society recommendations in minimal invasive liver surgery

Moosburner,

Dahlke,

Neudecker

et al. 2024

Langenbecks Arch Surg

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“…Analisou-se a maior titulação entre os autores dos artigos a partir da análise do currículo de todos os autores dos artigos e verificou-se que em 9 artigos (56,3%) o autor com o nível de titulação mais alto era Doutor, em 3 artigos (18,8%) a maior titulação era de Mestrado e em 3 artigos a maior titulação era de Medical Doctor (MD), que representa os médicos ao terminarem o curso de graduação. Quanto à presença de autores pesquisadores da área de custos, a qual foi realizada também através do currículo dos autores, identificou-se que em apenas 4 artigos (25,0%) (em BIWERSI et al, 2009;BRENNFLECK et al, 2021;NANGINO et al, 2012;SHULKIN et al, 1993) estavam presentes pesquisadores da área de custos. Observou-se, também, se houve envolvimento do setor contábil do hospital na avaliação de custos.…”

Section: Variáveis Básicasunclassified

“…Constatou-se que em 6 estudos (37,5%) a área contábil participou (em: ARNOLD et al, 2010;BRENNFLECK et al, 2021;NANGINO et al, 2012;OLSEN et al, 2008;SCHWEIZER et al, 2014;VON STRAUSS et al, 2019), enquanto 10 artigos (62,5%) não fizeram referência ao setor (BIWERSI et al, 2009;BRUN-BUISSON et al, 2003;JIA et al, 2019;KANERVA et al, 2007;PENEL et al, 2008;SCHECKLER, 1980;SHULKIN et al, 1993;SPENGLER;GREENOUGH, 1978;WAKEFIELD et al, 1988;WICK et al, 2011).…”

Section: Variáveis Básicasunclassified

“…Dos artigos do PB, em 8 não foi possível caracterizar o método de custeio empregado. Dentre estes, 5 (31,3%) descreveram os dados coletados, entretanto, de forma insuficiente para a identificação de mão-de-obra direta, materiais diretos, custos indiretos e despesas ou consideraram, para avaliação de custos, a inclusão de diária hospitalar sem descrever quais variáveis estavam presentes (ARNOLD et al, 2010;PENEL et al, 2008;SCHECKLER, 1980;SPENGLER;GREENOUGH, 1978;WAKEFIELD et al, 1988), e 3 (18,8%) não descreviam as categorias de custos utilizadas (BRENNFLECK et al, 2021;OLIVEIRA NANGINO et al, 2012;WICK et al, 2011).…”

Section: Variáveis Básicasunclassified

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Custos De Infecções Hospitalares

Gomes,

Gasparetto

2023

RAHIS

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Objetivo: Investigar as características das pesquisas científicas sobre custos de infecções hospitalares, para gerar conhecimento e identificar possibilidades de pesquisas futuras. Método: Utilizou-se como metodologia a ferramenta ProKnow-C para identificar e selecionar publicações relevantes sobre a temática, realizar análise bibliométrica descritiva, elaborar um mapa sintetizando os caminhos seguidos pela literatura, produzir uma análise sistêmica quanto à interpretação dos artigos e gerar uma agenda de pesquisa apresentando recomendações para pesquisadores que almejam investigar e produzir conhecimento sobre a temática. Resultados: Por se tratar de estudos desenvolvidos predominantemente por pesquisadores da área da saúde, o rigor quanto à classificação de custos e a preocupação em evidenciar qual o método de custeio empregado, com a terminologia técnica da área de custos, não foi uma preocupação desses estudos. Conclusão: Os achados sinalizam a necessidade de uma agregação de conhecimentos entre pesquisadores da área de custos e da área da saúde, para expandir e aperfeiçoar as evidências científicas e a adequação informacional ao que os tomadores de decisão da área necessitam.

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“… 4 Surgical site infections increase patient discomfort, delay adjuvant treatments, impose higher financial burdens, and lowers quality of life. 5 …”

Section: Introductionmentioning

confidence: 99%

The efficacy of negative pressure wound therapy after hepatopancreatobiliary surgery: A systematic review and meta-analysis

Ren¹,

Jiang²,

Chen³

et al. 2022

Pak J Med Sci

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Objective: To evaluate the comparative influence of NPT and standard surgical dressing administration on incidence risk for surgical site infections, complications, and hospital readmission after hepatopancreatobiliary surgery. Methods: Five databases were systematically searched according to PRISMA guidelines. These databases included Web of Science, MEDLINE, CENTRAL, EMBASE, and Scopus for eligible studies published prior to March 2021. With eligible studies, we conducted a random-effects meta-analysis to evaluate comparative outcomes such as superficial surgical infection, deep surgical infection, seroma incidence, hematoma incidence, and hospital re-admission in patients receiving NPT or standard surgical dressings after hepatopancreatobiliary surgery. Results: The search strategy yielded 963 studies, with six studies meeting inclusion criteria. Odds of superficial surgical site infection (OR: 1.58), deep surgical site infection (1.43), seroma complication (1.64), hematoma complication (0.40) were insignificantly different between patients receiving NPT and standard surgical dressing. The odds of hospital re-admission rate (2.37), however, were elevated in patients receiving standard surgical dressing relative to those receiving NPT. Conclusion: This meta-analysis shows that NPT usage slightly reduces risk of hospital readmission as compared to standard surgical dressing. We did not observe any significant effect of NPT on superficial, deep surgical infections, seroma, and haematoma outcomes following hepatopancreatobiliary surgery. These findings may aid clinicians in stratifying risk and selecting treatment strategy in patients undergoing hepatopancreatobiliary surgery. doi: https://doi.org/10.12669/pjms.38.8.6601 How to cite this:Ren B, Jiang X, Chen J, Mo J. The efficacy of negative pressure wound therapy after hepatopancreatobiliary surgery: A systematic review and meta-analysis. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.6601 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Surgical Site Infections and their economic significance in hepatopancreatobiliary surgery: A retrospective incidence, cost, and reimbursement analysis in a German centre of the highest level of care

Cited by 7 publications

References 15 publications

From morbidity reduction to cost-effectiveness: Enhanced recovery after surgery (ERAS) society recommendations in minimal invasive liver surgery

From morbidity reduction to cost-effectiveness: Enhanced recovery after surgery (ERAS) society recommendations in minimal invasive liver surgery

Custos De Infecções Hospitalares

The efficacy of negative pressure wound therapy after hepatopancreatobiliary surgery: A systematic review and meta-analysis

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