The economic burden of postoperative complications measured by the Comprehensive Complication Index® occurring in patients undergoing elective major hepatopancreaticobiliary surgery in a London tertiary referral hospital – A prospective health economics study
- Postoperative complications have a tremendous impact on in-hospital costs per case and complications.
- The novel Comprehensive Complication Index® (CCI®) summarizes all postoperative complications and is more sensitive than existing morbidity endpoints.
- The purpose of this study is to:
- Assess the correlation of CCI® with in-hospital costs.
- Establish the cost per unit of CCI for each different procedure.
- Assess the economic burden they represent.
- This will be a prospective study including all consecutive patients undergoing elective major hepatopancreaticobiliary surgery at the Royal Free Hospital in London.
- Data collection will include:
- Patient demographics
- Disease and operation characteristics
- Postoperative morbidity
- Intensive care unit and hospital stay
- The total costs per patient will be obtained from the finance department of the hospital.
- Fully anonymised data will be collected without any patient identifiers.
- In the pilot phase of this study, a sample size calculation using the standard bivariate model, with a two-sided alpha of 0.05 and power of 0.80, will be conducted after having included 30 cases to estimate the correlation coefficient of the CCI® with the total in-hospital costs.
- Univariate analysis will include correlation of the CCI® with costs, overall and the subgroups of the different procedures (complex biliary, minor and major liver surgery, pancreatic surgery).
- The CCI® as well as the absolute in-hospital costs will be compared among the different types of procedures with non-parametric tests.
- Multivariate linear regression analysis will be performed using a multivariate linear regression model adjusted for potential confounders.
- This study will highlight a relevant savings capacity for major surgical procedures and supports all efforts to lower negative events in the postoperative course.
Click here to access the CoCoS.surgery protocol.