Patient Age Significantly Influences Post-Esophagectomy Inpatient Mortality, Length of Stay, Hospital Charges, and Discharge Disposition

Esther H Cha, Gregory Burgoyne and Richard F Heitmiller

Department of Surgery, MedStar Union Memorial Hospital, USA

^*Correspondance to: Richard F Heitmiller 

 PDF  Full Text DOI: 10.25107/2474-1647.1539

Abstract

Background: There are conflicting reports on the merits of surgery in older esophageal cancer patients. The objective of this study is to track inpatient outcome, hospital charges, and discharge disposition as a function of age.Study
Design: The Nationwide Inpatient Sample was searched for all patients from 2006 to 2010 with a primary diagnosis of esophageal cancer (ICD-9: 150) and underwent esophagectomy (ICD-9: 424). Cervical and upper third malignancies (ICD-9: 150.0 & 150.3) were excluded. Data recorded included age, gender, mortality, length of stay (LOS), hospital charges, discharge, disposition, and diagnosis and procedure codes. Patients were stratified into three age groups: <55; 55-74; 75 years and older. Results were analyzed using Chi2 and ANOVA.Results: 9,970 patients were included in this study. 81.2% were male. Mean age, mortality, LOS and charges were 63.3 years, 6.1%, 16.9 days and $161,229 respectively. For the age groups <55, 55-74, ≥75 respectively, mortality was 2.5, 6.3, 10.3% (p<0.01); LOS was 15.3, 16.8, 19.4 days (p<0.01). There was a significant increase need for post-discharge skilled nursing facility based on age. Home health care was common for all groups (41.2-46.4%).Conclusion: Post-esophagectomy in-patient mortality, LOS, inpatient charges and the need for post-discharge to skilled nursing facility increase significantly with age. Inpatient charges alone underestimate the overall cost of esophagectomy care. These results should help in selecting esophageal cancer patients for surgery.

Keywords

Esophagectomy; Esophageal cancer; Age; Nationwide inpatient database; Esophagectomy; Cancer; Patient age; Mortality; Charges; Discharge; Disposition; Length of stay; LOS

Cite the article

Patient Age Significantly Influences Post-Esophagectomy Inpatient Mortality, Length of Stay, Hospital Charges, and Discharge Disposition. Clin Surg. 2017; 2: 1539.