John Agzarian, MD, MPH, Sue L. Visscher, PhD, Ariel W

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Presentation transcript:

The cost burden of clinically significant esophageal anastomotic leaks—a steep price to pay John Agzarian, MD, MPH, Sue L. Visscher, PhD, Ariel W. Knight, MD, Mark S. Allen, MD, Stephen D. Cassivi, MD, MSc, Francis C. Nichols, MD, K. Robert Shen, MD, Dennis Wigle, MD, PhD, Shanda H. Blackmon, MD, MPH The Journal of Thoracic and Cardiovascular Surgery Volume 157, Issue 5, Pages 2086-2092 (May 2019) DOI: 10.1016/j.jtcvs.2018.10.137 Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Consort diagram. CRT, Chemoradiotherapy. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 2086-2092DOI: (10.1016/j.jtcvs.2018.10.137) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Total treatment standardized costs per patient. This graph highlights the per-patient standardized costs associated with the index esophagectomy, as well as the anastomotic leak treatment. The results are depicted according to the distribution of cost based on service rendered. ICU, Intensive care unit; IV, intravenous; IQR, interquartile range. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 2086-2092DOI: (10.1016/j.jtcvs.2018.10.137) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Post leak initial hospitalization standardized costs per patient—relative cost distribution of services provided to patients after the diagnosis of a leak to the point of gastrointestinal continuity. ICU, Intensive care unit; IV, intravenous; IQR, interquartile range. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 2086-2092DOI: (10.1016/j.jtcvs.2018.10.137) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Index surgery versus leak treatment standardized costs per patient. The graph demonstrates the comparative standardized costs for the 24 patients. Surgery costs account for services rendered from time of index operation prior to the detection of a leak. Leak treatment costs account for services provided to patients from time of leak diagnosis to establishing gastrointestinal continuity or death. IQR, Interquartile range. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 2086-2092DOI: (10.1016/j.jtcvs.2018.10.137) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Total treatment standardized costs per patient. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 2086-2092DOI: (10.1016/j.jtcvs.2018.10.137) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Video 1 Performance of a side-to-side video-assisted thoracoscopic (VATS) intrathoracic esophagogastric anastomosis. Video available at: https://www.jtcvs.org/article/S0022-5223(18)32931-3/fulltext. The Journal of Thoracic and Cardiovascular Surgery 2019 157, 2086-2092DOI: (10.1016/j.jtcvs.2018.10.137) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions