PMID- 29133112
OWN - NLM
STAT- MEDLINE
DCOM- 20180910
LR  - 20180910
IS  - 1532-7361 (Electronic)
IS  - 0039-6060 (Linking)
VI  - 163
IP  - 4
DP  - 2018 Apr
TI  - Persistent abdominal pain after laparoscopic cholecystectomy is associated with
      increased healthcare consumption and sick leave.
PG  - 661-666
LID - S0039-6060(17)30552-4 [pii]
LID - 10.1016/j.surg.2017.09.004 [doi]
AB  - BACKGROUND: Although, 33% to 40% of symptomatic gallstone patients reported
      persistent abdominal pain after laparoscopic cholecystectomy, there is no data on
      the burden of this pain to the healthcare system and society at large. This study
      determined healthcare consumption, sick leave, and costs in patients with
      persistent abdominal pain after laparoscopic cholecystectomy. Secondly,
      predictive factors for healthcare consumption were assessed. METHODS: This
      cross-sectional study included all 146 patients with persistent abdominal pain
      (patient-reported on Gastro-Intestinal Quality of Life Index (score 0-3) 24 weeks
      after laparoscopic cholecystectomy, derived from a previous prospective cohort.
      Healthcare consumption was assessed using Medical Consumption Questionnaire and
      medical records, and sick leave using Productivity Cost Questionnaire. Costs were
      calculated according "Guideline for performing economic evaluations in
      healthcare." Predictors of healthcare consumption were assessed using logistic
      regression analysis. RESULTS: In the study, 124/146 patients (85%) responded
      after mean follow-up of 31.0 months (standard deviation 6.5); 104 were female,
      mean age of responders was 52 years. Sixty-nine patients needed additional
      healthcare; 30.6% primary care; 37.1% secondary care; 16% emergency department
      admission; 8.9% hospital admission; 33.9% diagnostic procedures; 17.7%
      medication; 5.6% other interventions. Medical costs were $555 (BCa 95% confidence
      interval, $329-$852) and costs of sick leave were $361 (Bias-corrected and
      accelerated (BCa) 95% confidence interval, $189-$566) per year per patient.
      Younger age (odds ratio 0.95, 95% confidence interval, 0.92-0.98) and higher
      postoperative pain score (odds ratio 1.02, 95% confidence interval, 1.01-1.04)
      were associated with increased healthcare consumption. CONCLUSION: Persistent
      abdominal pain after laparoscopic cholecystectomy is associated with additional
      healthcare in 56% of patients. Yearly, medical costs and costs of sick leave are 
      20% of the initial costs of laparoscopic cholecystectomy.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Wennmacker, Sarah Z
AU  - Wennmacker SZ
AD  - Department of Surgery, Radboud University Medical Center, Nijmegen, The
      Netherlands. Electronic address: sarah.wennmacker@radboudumc.nl.
FAU - Dijkgraaf, Marcel G W
AU  - Dijkgraaf MGW
AD  - Clinical Research Unit, Academic Medical Center, Amsterdam, The Netherlands.
FAU - Westert, Gert P
AU  - Westert GP
AD  - Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud
      University Medical Center, Nijmegen, The Netherlands.
FAU - Drenth, Joost P H
AU  - Drenth JPH
AD  - Department of Gastroenterology & Hepathology, Radboud University Medical Center, 
      Nijmegen, The Netherlands.
FAU - van Laarhoven, Cornelis J H M
AU  - van Laarhoven CJHM
AD  - Department of Surgery, Radboud University Medical Center, Nijmegen, The
      Netherlands.
FAU - de Reuver, Philip R
AU  - de Reuver PR
AD  - Department of Surgery, Radboud University Medical Center, Nijmegen, The
      Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20171110
PL  - United States
TA  - Surgery
JT  - Surgery
JID - 0417347
SB  - AIM
SB  - IM
MH  - Abdominal Pain/*economics/etiology
MH  - Adult
MH  - Aged
MH  - Cholecystectomy, Laparoscopic/*adverse effects
MH  - Cross-Sectional Studies
MH  - Delivery of Health Care/economics/*utilization
MH  - Female
MH  - Gallstones/complications/economics/surgery
MH  - *Health Care Costs
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pain, Postoperative/*economics/etiology
MH  - *Sick Leave
EDAT- 2017/11/15 06:00
MHDA- 2018/09/11 06:00
CRDT- 2017/11/15 06:00
PHST- 2017/02/25 00:00 [received]
PHST- 2017/08/04 00:00 [revised]
PHST- 2017/09/16 00:00 [accepted]
PHST- 2017/11/15 06:00 [pubmed]
PHST- 2018/09/11 06:00 [medline]
PHST- 2017/11/15 06:00 [entrez]
AID - S0039-6060(17)30552-4 [pii]
AID - 10.1016/j.surg.2017.09.004 [doi]
PST - ppublish
SO  - Surgery. 2018 Apr;163(4):661-666. doi: 10.1016/j.surg.2017.09.004. Epub 2017 Nov 
      10.