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

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Presentation on theme: "John Agzarian, MD, MPH, Sue L. Visscher, PhD, Ariel W"— Presentation transcript:

1 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 (May 2019) DOI: /j.jtcvs Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Consort diagram. CRT, Chemoradiotherapy.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

3 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  , DOI: ( /j.jtcvs ) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

4 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  , DOI: ( /j.jtcvs ) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

5 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  , DOI: ( /j.jtcvs ) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

6 Total treatment standardized costs per patient.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

7 Video 1 Performance of a side-to-side video-assisted thoracoscopic (VATS) intrathoracic esophagogastric anastomosis. Video available at: The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions


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