Study shows economic impact of post-op delirium
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Results of a study reveal the impact post-operative delirium has on health care costs in the USA. Data from the study shows that if delirium were prevented or made less severe for patients, it could reduce health care costs by $33 billion per year, that is, $44,300 per patient per year. Severe delirium resulted in an additional $56,500 per patient per year, as compared to routine health care costs for older post-operative patients.

The objective of this JAMA Surgery was to evaluate current 1-year health care costs attributable to postoperative delirium in older patients undergoing elective surgery.

This prospective cohort study included 497 patients from the Successful Aging after Elective Surgery (SAGES) study, an ongoing cohort study of older adults undergoing major elective surgery. Eligible surgical procedures included total hip or knee replacement; lumbar, cervical, or sacral laminectomy; lower extremity arterial bypass surgery; open abdominal aortic aneurysm repair; and open or laparoscopic colectomy. Data were analyzed.

Of the 566 patients who were eligible for the study, a total of 497 patients were enrolled after exclusion criteria were applied. During the index hospitalization, 122 patients developed postoperative delirium, whereas 375 did not.

--Patients with delirium had significantly higher unadjusted health care costs than patients without delirium.

--After adjusting for relevant confounders, the cumulative health care costs attributable to delirium were $44291 per patient per year, with the majority of costs coming from the first 90 days: index hospitalization, subsequent rehospitalizations, and post-acute rehabilitation stays.

--Health care costs increased directly and significantly with the level of delirium severity, suggesting an exposure-response relationship.

--The adjusted mean cumulative costs attributable to severe delirium were $56474 per patient per year.

--Extrapolating nationally, the health care costs attributable to postoperative delirium were estimated at $32.9 billion per year.

These findings suggest that the economic outcomes of delirium and severe delirium after elective surgery are substantial, rivaling costs associated with cardiovascular disease and diabetes. These results highlight the need for policy imperatives to address delirium as a large-scale public health issue.

Source: https://jamanetwork.com/journals/jamasurgery/article-abstract/2776767
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