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A nationwide population-based study on the clinical and economic burden of anastomotic leakage in colorectal surgery

AIM: Anastomotic leakage (AL) is one of the most dreaded complications in colorectal surgery. In 2013, the International Classification of Diseases code K91.83 for AL was introduced in Germany, allowing nationwide analysis of AL rates and associated parameters. The aim of this population-based study...

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Autores principales: Weber, Marie-Christin, Berlet, Maximilian, Stoess, Christian, Reischl, Stefan, Wilhelm, Dirk, Friess, Helmut, Neumann, Philipp-Alexander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868041/
https://www.ncbi.nlm.nih.gov/pubmed/36683099
http://dx.doi.org/10.1007/s00423-023-02809-4
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author Weber, Marie-Christin
Berlet, Maximilian
Stoess, Christian
Reischl, Stefan
Wilhelm, Dirk
Friess, Helmut
Neumann, Philipp-Alexander
author_facet Weber, Marie-Christin
Berlet, Maximilian
Stoess, Christian
Reischl, Stefan
Wilhelm, Dirk
Friess, Helmut
Neumann, Philipp-Alexander
author_sort Weber, Marie-Christin
collection PubMed
description AIM: Anastomotic leakage (AL) is one of the most dreaded complications in colorectal surgery. In 2013, the International Classification of Diseases code K91.83 for AL was introduced in Germany, allowing nationwide analysis of AL rates and associated parameters. The aim of this population-based study was to investigate the current incidence, risk factors, mortality, clinical management, and associated costs of AL in colorectal surgery. METHODS: A data query was performed based on diagnosis-related group data of all hospital cases of inpatients undergoing colon or sphincter-preserving rectal resections between 2013 and 2018 in Germany. RESULTS: A total number of 690,690 inpatient cases were included in this study. AL rates were 6.7% for colon resections and 9.2% for rectal resections in 2018. Regarding the treatment of AL, the application of endoluminal vacuum therapy increased during the studied period, while rates of relaparotomy, abdominal vacuum therapy, and terminal enterostomy remained stable. AL was associated with significantly increased in-house mortality (7.11% vs. 20.11% for colon resections and 3.52% vs. 11.33% for rectal resections in 2018) and higher socioeconomic costs (mean hospital reimbursement volume per case: 14,877€ (no AL) vs. 37,521€ (AL) for colon resections and 14,602€ (no AL) vs. 30,606€ (AL) for rectal resections in 2018). CONCLUSIONS: During the studied time period, AL rates did not decrease, and associated mortality remained at a high level. Our study provides updated population-based data on the clinical and economic burden of AL in Germany. Focused research in the field of AL is still urgently necessary to develop targeted strategies to prevent AL, improve patient care, and decrease socioeconomic costs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00423-023-02809-4.
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spelling pubmed-98680412023-01-24 A nationwide population-based study on the clinical and economic burden of anastomotic leakage in colorectal surgery Weber, Marie-Christin Berlet, Maximilian Stoess, Christian Reischl, Stefan Wilhelm, Dirk Friess, Helmut Neumann, Philipp-Alexander Langenbecks Arch Surg Research AIM: Anastomotic leakage (AL) is one of the most dreaded complications in colorectal surgery. In 2013, the International Classification of Diseases code K91.83 for AL was introduced in Germany, allowing nationwide analysis of AL rates and associated parameters. The aim of this population-based study was to investigate the current incidence, risk factors, mortality, clinical management, and associated costs of AL in colorectal surgery. METHODS: A data query was performed based on diagnosis-related group data of all hospital cases of inpatients undergoing colon or sphincter-preserving rectal resections between 2013 and 2018 in Germany. RESULTS: A total number of 690,690 inpatient cases were included in this study. AL rates were 6.7% for colon resections and 9.2% for rectal resections in 2018. Regarding the treatment of AL, the application of endoluminal vacuum therapy increased during the studied period, while rates of relaparotomy, abdominal vacuum therapy, and terminal enterostomy remained stable. AL was associated with significantly increased in-house mortality (7.11% vs. 20.11% for colon resections and 3.52% vs. 11.33% for rectal resections in 2018) and higher socioeconomic costs (mean hospital reimbursement volume per case: 14,877€ (no AL) vs. 37,521€ (AL) for colon resections and 14,602€ (no AL) vs. 30,606€ (AL) for rectal resections in 2018). CONCLUSIONS: During the studied time period, AL rates did not decrease, and associated mortality remained at a high level. Our study provides updated population-based data on the clinical and economic burden of AL in Germany. Focused research in the field of AL is still urgently necessary to develop targeted strategies to prevent AL, improve patient care, and decrease socioeconomic costs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00423-023-02809-4. Springer Berlin Heidelberg 2023-01-23 2023 /pmc/articles/PMC9868041/ /pubmed/36683099 http://dx.doi.org/10.1007/s00423-023-02809-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Weber, Marie-Christin
Berlet, Maximilian
Stoess, Christian
Reischl, Stefan
Wilhelm, Dirk
Friess, Helmut
Neumann, Philipp-Alexander
A nationwide population-based study on the clinical and economic burden of anastomotic leakage in colorectal surgery
title A nationwide population-based study on the clinical and economic burden of anastomotic leakage in colorectal surgery
title_full A nationwide population-based study on the clinical and economic burden of anastomotic leakage in colorectal surgery
title_fullStr A nationwide population-based study on the clinical and economic burden of anastomotic leakage in colorectal surgery
title_full_unstemmed A nationwide population-based study on the clinical and economic burden of anastomotic leakage in colorectal surgery
title_short A nationwide population-based study on the clinical and economic burden of anastomotic leakage in colorectal surgery
title_sort nationwide population-based study on the clinical and economic burden of anastomotic leakage in colorectal surgery
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868041/
https://www.ncbi.nlm.nih.gov/pubmed/36683099
http://dx.doi.org/10.1007/s00423-023-02809-4
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